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General NPI Number Information
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NPI Number | 1326466228
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Entity Type | Organization
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Legal Business Name | DR. CHIANN-WEN YANG PROFESSIONAL OPTOMETRIC CORPORATION
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Dates
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Enumeration Date | 03/29/2014
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Last Update Date | 03/29/2014
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Provider Practice Location Address
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Address Line | 5630 COTTLE ROAD
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City | SAN JOSE
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State | CA
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Zip | 95123-3696
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Country | US
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Telephone | 408-227-1681
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Fax | 408-227-1681
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Provider Business Mailing Address
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Address Line | 125 BELVALE DR
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City | LOS GATOS
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State | CA
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Zip | 95032-5112
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHIANN-WEN YANG
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Credential |
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Telephone | 408-365-4120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT11985 TPL
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License Number State | CA
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