Provider Demographics
NPI:1922524925
Name:YANG, ESTHER SOPHIA
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:SOPHIA
Last Name:YANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 S ROBERTSON BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-1642
Mailing Address - Country:US
Mailing Address - Phone:310-274-0653
Mailing Address - Fax:562-420-4149
Practice Address - Street 1:930 S ROBERTSON BLVD STE C
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1642
Practice Address - Country:US
Practice Address - Phone:310-274-0653
Practice Address - Fax:310-274-0653
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33823TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist