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General NPI Number Information
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NPI Number | 1912480906
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Entity Type | Individual
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Provider Name | SHANGXIN YANG PHD, D(ABMM)
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Gender | Male
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Dates
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Enumeration Date | 09/14/2018
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Last Update Date | 09/14/2018
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Provider Practice Location Address
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Address Line | 11633 SAN VICENTE BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90049-6511
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Country | US
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Telephone | 310-794-3614
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Fax |
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Provider Business Mailing Address
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Address Line | 28108 RIDGEFERN CT
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-3266
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Country | US
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Telephone | 626-202-3167
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246QM0900X
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Taxonomy Name | Microbiology Specialist/Technologist
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License Number | MTA43523
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License Number State | CA
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