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General NPI Number Information
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NPI Number | 1932249901
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Entity Type | Individual
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Provider Name | YANGZI MAGGIE JIANG O.D.
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 05/17/2019
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Provider Practice Location Address
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Address Line | 7571 S 3800 W
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City | WEST JORDAN
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State | UT
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Zip | 84084-4319
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Country | US
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Telephone | 801-282-5682
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Fax | 801-282-5684
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Provider Business Mailing Address
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Address Line | 1918 E RICH WAY
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City | SALT LAKE CITY
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State | UT
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Zip | 84121-4881
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Country | US
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Telephone | 801-505-9886
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Fax | 801-282-5684
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | UVT007131
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License Number State | NY
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