Provider Demographics
NPI:1245850189
Name:YANG INTERNAL MEDICINE SERVICE
Entity type:Organization
Organization Name:YANG INTERNAL MEDICINE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOSPITALIST
Authorized Official - Prefix:
Authorized Official - First Name:YANG
Authorized Official - Middle Name:
Authorized Official - Last Name:XUAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:602-235-0519
Mailing Address - Street 1:3150 W DRAKE ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2311
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1500 S MILL AVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-6699
Practice Address - Country:US
Practice Address - Phone:480-784-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service