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General NPI Number Information
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NPI Number | 1235620261
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Entity Type | Organization
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Legal Business Name | YANGDONG HE MEDICAL CORPORATION
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Dates
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Enumeration Date | 05/25/2018
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Last Update Date | 01/06/2020
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Provider Practice Location Address
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Address Line | 5411 DUNCASTER PL
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739
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Country | US
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Telephone | 734-358-2738
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Fax |
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Provider Business Mailing Address
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Address Line | 5411 DUNCASTER PL
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-2603
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Country | US
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Telephone | 734-358-2738
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YANGDONG HE
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Credential | MD
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Telephone | 734-358-2738
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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 | A135621
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License Number State | CA
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