MEDICARE: DR. SUNG CHUL YANG MD

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	207RN0300X	Nephrology Physician	A43185	CA

General Provider Information

NPI Number	:	1871562900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUNG CHUL YANG MD

Provider Business Mailing Address
First Line	:	PO BOX 2768
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93539-2768
Country	:	US
Telephone Number	:	661-948-1388
Fax Number	:	661-948-1223

Provider Business Practice Location Address
First Line	:	1759 W AVENUE J
Second Line	:	STE 101
City	:	LANCASTER
State	:	CA
Zip	:	93534-2703
Country	:	US
Telephone Number	:	661-948-1388
Fax Number	:	661-948-1223

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	02/23/2016

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