Healthcare Provider Details

I. General information

NPI: 1508745274
Provider Name (Legal Business Name): ROGER YANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 TRANSFER RD # 35
SAINT PAUL MN
55114-1422
US

IV. Provider business mailing address

800 TRANSFER RD # 35
SAINT PAUL MN
55114-1422
US

V. Phone/Fax

Practice location:
  • Phone: 651-917-4029
  • Fax:
Mailing address:
  • Phone: 651-917-4029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number122486
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: