Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 45364 | CA |
NPI | 1114269131 |
---|---|
Provider Name | Dr. Denny Yen-Kai Fang |
First Address | Irvine, CA 92618-0409 |
Second Address | Irvine, CA 92618-0409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2013 |
Last Update Date | 18/03/2013 |