Provider Demographics
NPI:1558924076
Name:LI, DAVID YANG (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:YANG
Last Name:LI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YANG
Other - Middle Name:
Other - Last Name:LI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:191 BURGUNDY DR
Mailing Address - Street 2:
Mailing Address - City:OAKVILLE
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L6J4E9
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-820-9502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program