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General NPI Number Information
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NPI Number | 1417101908
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Entity Type | Organization
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Legal Business Name | TOM YANG MD INC
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Dates
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Enumeration Date | 11/10/2008
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 503 S WATSON ST
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City | VISALIA
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State | CA
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Zip | 93277-2641
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Country | US
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Telephone | 559-623-9636
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Fax | 559-623-9951
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Provider Business Mailing Address
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Address Line | PO BOX 6758
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City | VISALIA
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State | CA
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Zip | 93290-6758
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Country | US
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Telephone | 559-623-9636
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Fax | 559-623-9951
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Authorized Official
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Title or Position | CEO
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Name | DR. TOM YANG
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Credential | M.D.
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Telephone | 559-623-9636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | A86613
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License Number State | CA
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