MEDICARE: KEVIN YANG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	372600000X	Adult Companion

General Provider Information

NPI Number	:	1003687765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN YANG

Provider Business Mailing Address
First Line	:	5193 FADING SUNSET DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-9137
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5193 FADING SUNSET DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-9137
Country	:	US
Telephone Number	:	732-609-5839
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2024
Last Update Date	:	01/11/2024

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Directions to “ KEVIN YANG ” Practice Location

Language	Start Address	Practice Location

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