Provider Demographics
NPI:1982646022
Name:YANG, CHIEH-JEN CALVIN (MD,)
Entity Type:Individual
Prefix:DR
First Name:CHIEH-JEN
Middle Name:CALVIN
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 1:320 S GARFIELD AVE
Mailing Address - Street 2:SUITE #102
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3886
Mailing Address - Country:US
Mailing Address - Phone:626-281-4487
Mailing Address - Fax:626-457-5630
Practice Address - Street 1:320 S GARFIELD AVE
Practice Address - Street 2:SUITE #102
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3886
Practice Address - Country:US
Practice Address - Phone:626-281-4487
Practice Address - Fax:626-457-5630
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
CAA451942085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A451940Medicaid
CAWA45194AMedicare PIN
CAA54873Medicare UPIN
CAW20060Medicare PIN
CAA45194Medicare PIN