=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962441592
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRIAN E. YANG MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2006
-----------------------------------------------------
Last Update Date | 09/24/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25500 MEDICAL CENTER DR
-----------------------------------------------------
City | MURRIETA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92562-5965
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-696-6251
-----------------------------------------------------
Fax | 951-696-6259
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25500 MEDICAL CENTER DR
-----------------------------------------------------
City | MURRIETA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92562-5965
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-696-6251
-----------------------------------------------------
Fax | 951-696-6259
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | A80596
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------