MEDICARE: YANGDC CHIROPRACTIC PROFESSIONAL CORPORATION

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	111N00000X	Chiropractor	29467	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC29467	OTHER	CA	MEDICARE PTIN

General Provider Information

NPI Number	:	1588107353
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YANGDC CHIROPRACTIC PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	7450 SAN RAMON RD
Second Line	:
City	:	DUBLIN
State	:	CA
Zip	:	94568-2338
Country	:	US
Telephone Number	:	925-829-8484
Fax Number	:	925-829-1806

Provider Business Practice Location Address
First Line	:	7450 SAN RAMON RD
Second Line	:
City	:	DUBLIN
State	:	CA
Zip	:	94568-2338
Country	:	US
Telephone Number	:	925-829-8484
Fax Number	:	925-829-1806

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JIM YANG
Credential	:	DC
Telephone Number	:	925-829-8484

Provider Enumeration Date	:	11/29/2016
Last Update Date	:	04/05/2024

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Directions to “YANGDC CHIROPRACTIC PROFESSIONAL CORPORATION ” Practice Location

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