Provider Demographics
NPI:1902435670
Name:GAO, JASON YANG
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:YANG
Last Name:GAO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1680 S GARFIELD AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-5413
Mailing Address - Country:US
Mailing Address - Phone:818-839-5280
Mailing Address - Fax:
Practice Address - Street 1:1680 S GARFIELD AVE STE 240
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-5413
Practice Address - Country:US
Practice Address - Phone:818-839-5280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-05
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA185420207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine