Provider Demographics
NPI:1497776165
Name:YANG, TZONG-SHIN (PT)
Entity Type:Individual
Prefix:MR
First Name:TZONG-SHIN
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:14785 JEFFREY RD
Mailing Address - Street 2:# 108
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-0408
Mailing Address - Country:US
Mailing Address - Phone:949-857-2221
Mailing Address - Fax:949-857-2227
Practice Address - Street 1:14785 JEFFREY RD
Practice Address - Street 2:# 108
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-0408
Practice Address - Country:US
Practice Address - Phone:949-857-2221
Practice Address - Fax:949-857-2227
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 17555225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT17555Medicare ID - Type UnspecifiedPHYSICAL THERAPIST