Healthcare Provider Details

I. General information

NPI: 1558352484
Provider Name (Legal Business Name): YUE PANG MOK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 09/06/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3593 S ARLINGTON RD
AKRON OH
44312-5271
US

IV. Provider business mailing address

3593 S ARLINGTON RD SUITE C.
AKRON OH
44312-5271
US

V. Phone/Fax

Practice location:
  • Phone: 330-896-1517
  • Fax: 330-896-2450
Mailing address:
  • Phone: 330-896-1517
  • Fax: 330-896-2450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number35038559M
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: