Provider Demographics
NPI:1497850333
Name:YANG, JIM (DC)
Entity Type:Individual
Prefix:DR
First Name:JIM
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7450 SAN RAMON RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2338
Mailing Address - Country:US
Mailing Address - Phone:925-829-8484
Mailing Address - Fax:
Practice Address - Street 1:7450 SAN RAMON RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2338
Practice Address - Country:US
Practice Address - Phone:925-829-8484
Practice Address - Fax:925-829-1806
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-29467111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor