Provider Demographics
NPI:1710080155
Name:YANG, SEUNG C (MD)
Entity Type:Individual
Prefix:DR
First Name:SEUNG
Middle Name:C
Last Name:YANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2083 COMPTON AVE
Mailing Address - Street 2:STE 203
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-3416
Mailing Address - Country:US
Mailing Address - Phone:951-735-1310
Mailing Address - Fax:951-735-8413
Practice Address - Street 1:2083 COMPTON AVE
Practice Address - Street 2:STE 203
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-3416
Practice Address - Country:US
Practice Address - Phone:951-735-1310
Practice Address - Fax:951-735-8413
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39844207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0475222Medicaid
CA0475222Medicaid
00A398440Medicare ID - Type Unspecified