Provider Demographics
NPI:1467432559
Name:YANG, ANDREW YUAN-SHUOH (OD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:YUAN-SHUOH
Last Name:YANG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 HILLVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94506-1311
Mailing Address - Country:US
Mailing Address - Phone:925-463-2150
Mailing Address - Fax:925-463-1186
Practice Address - Street 1:3901B SANTA RITA RD
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3462
Practice Address - Country:US
Practice Address - Phone:925-463-2150
Practice Address - Fax:925-463-1186
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11984 TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0119840Medicaid
CASD00119840Medicare PIN
CAZZZ93557ZMedicare ID - Type UnspecifiedMEDICARE
CASD0119840Medicaid