Provider Demographics
NPI:1558304949
Name:YANG, GEORGE T (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:T
Last Name:YANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 W ROWLAND ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-2943
Mailing Address - Country:US
Mailing Address - Phone:626-331-6411
Mailing Address - Fax:626-251-1559
Practice Address - Street 1:1535 W MERCED AVE
Practice Address - Street 2:SUITE # 301
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3404
Practice Address - Country:US
Practice Address - Phone:626-388-1330
Practice Address - Fax:626-962-7182
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33505207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A335050Medicaid
CACB226069Medicare PIN
CAA27169Medicare UPIN