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General NPI Number Information
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NPI Number | 1336462100
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Entity Type | Organization
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Legal Business Name | STANLEY W YANG, MD
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 03/09/2010
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Provider Practice Location Address
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Address Line | 530 N FERN AVE
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City | ONTARIO
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State | CA
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Zip | 91762-3210
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Country | US
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Telephone | 909-986-8818
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Fax | 909-391-9558
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Provider Business Mailing Address
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Address Line | 1060 E FOOTHILL BLVD SUITE 204
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City | UPLAND
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State | CA
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Zip | 91786-4070
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Country | US
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Telephone | 909-982-4706
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Fax | 909-946-8545
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Authorized Official
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Title or Position | OWNER
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Name | DR. STANLEY W YANG
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Credential | MD
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Telephone | 909-982-4706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A29756
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number | A297560
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License Number State | CA
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