Healthcare Provider Details

I. General information

NPI: 1699183285
Provider Name (Legal Business Name): LEWIS YANG MD.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2014
Last Update Date: 11/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E UNIVERSITY PKWY DEPT OF MEDICINE
BALTIMORE MD
21218-2829
US

IV. Provider business mailing address

2615 CHESTER AV
BAKERSFIELD CA
93301
US

V. Phone/Fax

Practice location:
  • Phone: 410-554-2284
  • Fax: 410-554-2184
Mailing address:
  • Phone: 661-395-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA147565
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: