Healthcare Provider Details
I. General information
NPI: 1750732657
Provider Name (Legal Business Name): PAUL YANG M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/22/2016
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 W CALIFORNIA BLVD
PASADENA CA
91105-3010
US
IV. Provider business mailing address
1107 FAIR OAKS AVE
SOUTH PASADENA CA
91030-3311
US
V. Phone/Fax
- Phone: 626-352-1444
- Fax:
- Phone: 626-842-7745
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | A150374 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: