Provider Demographics
NPI:1952501330
Name:YANG, JIN QUAN (MD)
Entity Type:Individual
Prefix:
First Name:JIN QUAN
Middle Name:
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 1:500 N GARFIELD AVE
Mailing Address - Street 2:STE 110
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1242
Mailing Address - Country:US
Mailing Address - Phone:910-926-6888
Mailing Address - Fax:
Practice Address - Street 1:500 N GARFIELD AVE STE 110
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1242
Practice Address - Country:US
Practice Address - Phone:310-926-6888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA106239207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine