Provider Demographics
NPI:1780208793
Name:JANG, DANIEL H (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:H
Last Name:JANG
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 1:1660 E HERNDON AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3346
Mailing Address - Country:US
Mailing Address - Phone:559-431-9753
Mailing Address - Fax:559-416-7029
Practice Address - Street 1:1660 E HERNDON AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3346
Practice Address - Country:US
Practice Address - Phone:559-431-9753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-04
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP05043207R00000X
CAA187092207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine