Provider Demographics
NPI:1871017517
Name:ORESTES, GUANG YANG (PT)
Entity Type:Individual
Prefix:
First Name:GUANG
Middle Name:YANG
Last Name:ORESTES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:GUANG
Other - Middle Name:
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2650 N TENAYA WAY STE 180
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-1110
Mailing Address - Country:US
Mailing Address - Phone:702-240-2952
Mailing Address - Fax:
Practice Address - Street 1:2650 N TENAYA WAY STE 180
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-1110
Practice Address - Country:US
Practice Address - Phone:702-240-2952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3597225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist