Provider Demographics
NPI:1114946696
Name:YANG, HONGHAO (MD)
Entity Type:Individual
Prefix:
First Name:HONGHAO
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HANK
Other - Middle Name:
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1411 S GARFIELD AVE STE 306&308
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-5022
Mailing Address - Country:US
Mailing Address - Phone:626-312-9500
Mailing Address - Fax:626-312-9588
Practice Address - Street 1:1411 S GARFIELD AVE STE 306&308
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-5022
Practice Address - Country:US
Practice Address - Phone:626-312-9500
Practice Address - Fax:626-312-9588
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63882174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A638820Medicaid
CAG89645Medicare UPIN
CACV125ZMedicare PIN
CA00A638820Medicaid