Provider Demographics
NPI:1326078015
Name:YANG, BEATRICE (MD)
Entity Type:Individual
Prefix:MISS
First Name:BEATRICE
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:KHIN
Other - Middle Name:HNIN
Other - Last Name:WAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3003 N CENTRAL AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2902
Mailing Address - Country:US
Mailing Address - Phone:602-685-6000
Mailing Address - Fax:602-629-0601
Practice Address - Street 1:4909 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-7735
Practice Address - Country:US
Practice Address - Phone:602-685-6000
Practice Address - Fax:602-629-0601
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ257412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ751330Medicaid
AZ1326078015OtherNPI
AZ751330Medicaid