MEDICARE: JOSEPH FU-SHOU YANG DDS

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	1223G0001X	General Practice Dentistry	G92251-01	CA

General Provider Information

NPI Number	:	1477759819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPH FU-SHOU YANG DDS

Provider Business Mailing Address
First Line	:	12220 VALLEY BLVD STE DE
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91732-3149
Country	:	US
Telephone Number	:	626-401-2554
Fax Number	:

Provider Business Practice Location Address
First Line	:	12220 VALLEY BLVD STE DE
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91732-3149
Country	:	US
Telephone Number	:	626-401-2554
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOSEPH FU-SHOU YANG
Credential	:
Telephone Number	:	626-401-2554

Provider Enumeration Date	:	06/22/2007
Last Update Date	:	06/25/2008

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