Provider Demographics
NPI:1457458267
Name:YANG, SHU PING (MD)
Entity Type:Individual
Prefix:DR
First Name:SHU
Middle Name:PING
Last Name:YANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHU
Other - Middle Name:PING
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 15645
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85060-5645
Mailing Address - Country:US
Mailing Address - Phone:602-840-3430
Mailing Address - Fax:
Practice Address - Street 1:4710 N 44TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3834
Practice Address - Country:US
Practice Address - Phone:602-840-3430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31838208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice