MEDICARE: PAO 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	3747P1801X	Personal Care Attendant		FM

General Provider Information

NPI Number	:	1497977417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAO YANG

Provider Business Mailing Address
First Line	:	4932 CAMDEN AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55430-3545
Country	:	US
Telephone Number	:	612-522-0356
Fax Number	:

Provider Business Practice Location Address
First Line	:	4932 CAMDEN AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55430-3545
Country	:	US
Telephone Number	:	612-522-0356
Fax Number	:

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	07/08/2007

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Directions to “ PAO YANG ” Practice Location

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