Provider Demographics
NPI:1528034154
Name:YANG, XIN (MB BCHIR)
Entity Type:Individual
Prefix:DR
First Name:XIN
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:MB BCHIR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 WEBSTER ST
Mailing Address - Street 2:SUITE 404-410
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3117
Mailing Address - Country:US
Mailing Address - Phone:510-549-4200
Mailing Address - Fax:510-433-0744
Practice Address - Street 1:3300 WEBSTER ST
Practice Address - Street 2:SUITE 410
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3117
Practice Address - Country:US
Practice Address - Phone:510-549-4200
Practice Address - Fax:510-433-0744
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC116778207R00000X
MA227615207R00000X, 207RC0000X
CAA111777207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A1117770Medicaid
CAD07203Medicare UPIN