Provider Demographics
NPI:1942403654
Name:YANG, JEFFREY HAN-NIEN (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:HAN-NIEN
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 1:4650 W SUNSET BLVD
Mailing Address - Street 2:MS# 76
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6062
Mailing Address - Country:US
Mailing Address - Phone:323-669-2110
Mailing Address - Fax:323-361-4429
Practice Address - Street 1:4650 W SUNSET BLVD
Practice Address - Street 2:MS# 53
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6062
Practice Address - Country:US
Practice Address - Phone:323-361-2350
Practice Address - Fax:323-361-4429
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA125815208000000X, 2080P0006X
MA242593208000000X, 390200000X
MI4301090194390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program