Provider Demographics
NPI:1043232358
Name:YANG, MICHAEL CHIH-KUO (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CHIH-KUO
Last Name:YANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 BELLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-2714
Mailing Address - Country:US
Mailing Address - Phone:626-292-1495
Mailing Address - Fax:
Practice Address - Street 1:529 E VALLEY BLVD STE 288A
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3694
Practice Address - Country:US
Practice Address - Phone:626-572-9201
Practice Address - Fax:626-572-9210
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30098111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor