Provider Demographics
NPI:1831126531
Name:YANG, ALLEN S (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:S
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:PO BOX 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:323-865-3105
Mailing Address - Fax:
Practice Address - Street 1:1441 EASTLAKE AVE
Practice Address - Street 2:NOR 8302E
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-0112
Practice Address - Country:US
Practice Address - Phone:323-865-3105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG35326207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1902846306OtherGROUP NPI
CA00A667930Medicaid
CACE1617OtherGROUP RAILROAD MEDICARE
CA1356390009OtherGROUP NPI
CAW11675OtherGROUP MEDICARE PIN
CA00A667930OtherBLUE SHIELD
CAGR0100430OtherGROUP MEDICAL
CAP00400221OtherRAILROAD MEDICARE
CAGR0016910OtherGROUP MEDICAID PIN
CAW18762OtherGROUP MEDICARE
CA00A667930Medicaid
CAGR0100430OtherGROUP MEDICAL