Provider Demographics
NPI:1972127967
Name:YANG, SIYUAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SIYUAN
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:GRADUATE MEDICAL EDUCATION
Mailing Address - Street 2:1050 LINDEN AVE.
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813
Mailing Address - Country:US
Mailing Address - Phone:562-491-9140
Mailing Address - Fax:562-491-9146
Practice Address - Street 1:GRADUATE MEDICAL EDUCATION
Practice Address - Street 2:1050 LINDEN AVE.
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813
Practice Address - Country:US
Practice Address - Phone:562-491-9140
Practice Address - Fax:562-491-9146
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPTL5589207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine