MEDICARE: FU-SHOU YANG D.D.S.

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	45198	CA

General Provider Information

NPI Number	:	1578556650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FU-SHOU YANG D.D.S.

Provider Business Mailing Address
First Line	:	1010 PARK AVE
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91007-6949
Country	:	US
Telephone Number	:	626-445-1414
Fax Number	:

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

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

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	07/08/2007

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