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General NPI Number Information
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NPI Number | 1184871345
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Entity Type | Organization
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Legal Business Name | PETER YANG MA MEDICAL INC
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Dates
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Enumeration Date | 08/19/2008
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 624 W DUARTE RD STE 208
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City | ARCADIA
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State | CA
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Zip | 91007-7675
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Country | US
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Telephone | 626-294-9978
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Fax | 626-294-9526
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Provider Business Mailing Address
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Address Line | 612 W DUARTE RD SUITE 505
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City | ARCADIA
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State | CA
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Zip | 91007
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Country | US
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Telephone | 626-294-9978
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Fax | 626-294-9526
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YANG MA
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Credential | M.D.
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Telephone | 626-294-9978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A53050
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License Number State | CA
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