Provider Demographics
NPI:1295235935
Name:GONG, YANPING (MD)
Entity type:Individual
Prefix:
First Name:YANPING
Middle Name:
Last Name:GONG
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 1:176 BEECHDALE CRES
Mailing Address - Street 2:
Mailing Address - City:SASKATOON
Mailing Address - State:SASKATCHEWAN
Mailing Address - Zip Code:703
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:176 BEECHDALE CRES
Practice Address - Street 2:
Practice Address - City:SASKATOON
Practice Address - State:SASKATCHEWAN
Practice Address - Zip Code:S7V 0A3
Practice Address - Country:CA
Practice Address - Phone:306-612-3888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.132077207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35.132077OtherMEDICAL LICENSE
FLME131687OtherMEDICAL LICENSE