Healthcare Provider Details

I. General information

NPI: 1992769327
Provider Name (Legal Business Name): YOUAPA S. YANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 04/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 SUCCESS BLVD.
PERRY OH
44081
US

IV. Provider business mailing address

P.O. BOX 714328
COLUMBUS OH
43271-4328
US

V. Phone/Fax

Practice location:
  • Phone: 440-375-8590
  • Fax: 440-259-2106
Mailing address:
  • Phone: 440-354-1985
  • Fax: 440-350-4938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.089159
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: