Provider Demographics
NPI:1609541192
Name:YANG, VICTOR SING (PA)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:SING
Last Name:YANG
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:36834 LIMETA TER
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-5630
Mailing Address - Country:US
Mailing Address - Phone:510-789-7280
Mailing Address - Fax:
Practice Address - Street 1:36834 LIMETA TER
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-5630
Practice Address - Country:US
Practice Address - Phone:510-789-7280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
CAPA60181363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant