Provider Demographics
NPI:1437386158
Name:YANG, JUSTIN SHU (MD)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:SHU
Last Name:YANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:4760 W SUNSET BLVD
Mailing Address - Street 2:1ST FLOOR ORTHOPEDICS
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6063
Mailing Address - Country:US
Mailing Address - Phone:800-954-8000
Mailing Address - Fax:323-783-6985
Practice Address - Street 1:4760 W SUNSET BLVD
Practice Address - Street 2:1ST FLOOR ORTHOPEDICS
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6063
Practice Address - Country:US
Practice Address - Phone:800-954-8000
Practice Address - Fax:323-783-6985
Is Sole Proprietor?:No
Enumeration Date:2009-06-20
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA136627207XX0005X, 207X00000X
CT052748207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine