Healthcare Provider Details

I. General information

NPI: 1508231333
Provider Name (Legal Business Name): LINDA YANG D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2015
Last Update Date: 12/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 LOMITA BLVD STE 402
TORRANCE CA
90505-4995
US

IV. Provider business mailing address

3400 LOMITA BLVD SUITE #402
TORRANCE CA
90505
US

V. Phone/Fax

Practice location:
  • Phone: 310-534-5500
  • Fax: 310-534-8026
Mailing address:
  • Phone: 310-534-5500
  • Fax: 310-534-8026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number29691
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: