Provider Demographics
NPI:1023087392
Name:YANG, MARCOS Y (MD)
Entity type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:Y
Last Name:YANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:310 TEJON PL
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-1204
Mailing Address - Country:US
Mailing Address - Phone:310-375-2403
Mailing Address - Fax:310-375-9652
Practice Address - Street 1:310 TEJON PL
Practice Address - Street 2:
Practice Address - City:PALOS VERDES ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-1204
Practice Address - Country:US
Practice Address - Phone:310-375-2403
Practice Address - Fax:310-375-9652
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA49035207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A490350Medicaid
CA00A490350Medicaid
CAF46625Medicare UPIN
CAA49035Medicare PIN