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General NPI Number Information
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NPI Number | 1083772867
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Entity Type | Organization
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Legal Business Name | JOOMO YANG, MD., INC.
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2403 CAMINO CORSO RIO
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-3613
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Country | US
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Telephone | 949-226-8416
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Fax | 949-226-8019
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Provider Business Mailing Address
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Address Line | 1001 AVENIDA PICO #C517
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-6957
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Country | US
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Telephone | 949-226-8416
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Fax | 949-226-8019
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOOMO YANG
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Credential | M.D.
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Telephone | 949-226-8416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A64412
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License Number State | CA
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