MEDICARE: FUGUI THERAPEUTICS INC

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	2083B0002X	Obesity Medicine (Preventive Medicine) Physician

General Provider Information

NPI Number	:	1699346346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FUGUI THERAPEUTICS INC

Provider Business Mailing Address
First Line	:	3926 PARK BLVD
Second Line	:
City	:	PALO ALTO
State	:	CA
Zip	:	94306-3306
Country	:	US
Telephone Number	:	650-400-1089
Fax Number	:

Provider Business Practice Location Address
First Line	:	3926 PARK BLVD
Second Line	:
City	:	PALO ALTO
State	:	CA
Zip	:	94306-3306
Country	:	US
Telephone Number	:	650-400-1089
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JUSAN YANG
Credential	:	MD (ECFMG), MS, PHD
Telephone Number	:	650-400-1089

Provider Enumeration Date	:	07/04/2021
Last Update Date	:	07/04/2021

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