MEDICARE: KE 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	183500000X	Pharmacist	87928	CA

General Provider Information

NPI Number	:	1295426385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KE YANG

Provider Business Mailing Address
First Line	:	6625 VIBRANT LOOP
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95119-1766
Country	:	US
Telephone Number	:	408-250-3888
Fax Number	:

Provider Business Practice Location Address
First Line	:	1718 SOQUEL AVE
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95062-1306
Country	:	US
Telephone Number	:	831-425-3911
Fax Number	:

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

Provider Enumeration Date	:	05/18/2023
Last Update Date	:	05/18/2023

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Directions to “ KE YANG ” Practice Location

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