Healthcare Provider Details

I. General information

NPI: 1720548928
Provider Name (Legal Business Name): YANG YANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW DEPT OF
WASHINGTON DC
20010-3017
US

IV. Provider business mailing address

110 IRVING ST NW DEPT OF
WASHINGTON DC
20010-3017
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-3536
  • Fax: 202-877-3699
Mailing address:
  • Phone: 202-877-3536
  • Fax: 202-877-3699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number329321
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: