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General NPI Number Information
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NPI Number | 1871890012
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Entity Type | Organization
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Legal Business Name | JOO SOCK YANG, M.D. MEDICAL CORPORATION
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 401 29TH ST 103
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City | OAKLAND
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State | CA
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Zip | 94609-3519
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Country | US
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Telephone | 510-893-7008
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Fax | 415-563-0308
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Provider Business Mailing Address
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Address Line | 401 29TH ST 103
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City | OAKLAND
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State | CA
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Zip | 94609-3519
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Country | US
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Telephone | 510-893-7008
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Fax | 415-563-0308
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOO SOCK YANG
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Credential | M.D.
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Telephone | 510-893-7008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A33778
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License Number State | CA
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