Provider Demographics
NPI:1225457922
Name:OUYANG, YICHENG
Entity Type:Individual
Prefix:
First Name:YICHENG
Middle Name:
Last Name:OUYANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 MANDELA PKWY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94608-4040
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:388 9TH ST
Practice Address - Street 2:STE 127
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4287
Practice Address - Country:US
Practice Address - Phone:510-452-7888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies