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General NPI Number Information
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NPI Number | 1790913127
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Entity Type | Organization
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Legal Business Name | TONY YANG D.D.S., M.D. CORP.
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Dates
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Enumeration Date | 06/24/2009
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Last Update Date | 06/24/2009
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Provider Practice Location Address
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Address Line | 801 N TUSTIN AVE STE 502
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City | SANTA ANA
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State | CA
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Zip | 92705-3609
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Country | US
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Telephone | 714-568-0188
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Fax |
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Provider Business Mailing Address
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Address Line | 801 N. TUSTIN AVE. SUITE 502
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City | SANTA ANA
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State | CA
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Zip | 92705
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Country | US
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Telephone | 714-568-0188
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. TONY YANG
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Credential | D.D.S., M.D.
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Telephone | 714-568-0188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number | OMS 84
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License Number State | CA
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