Provider Demographics
NPI:1952512618
Name:ANDY YANG, MD, INC
Entity Type:Organization
Organization Name:ANDY YANG, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-735-1310
Mailing Address - Street 1:802 MAGNOLIA AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3144
Mailing Address - Country:US
Mailing Address - Phone:951-735-8167
Mailing Address - Fax:951-735-8413
Practice Address - Street 1:802 MAGNOLIA AVE STE 202
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3144
Practice Address - Country:US
Practice Address - Phone:951-735-8167
Practice Address - Fax:951-735-8413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39844207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A398440Medicare ID - Type Unspecified