Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 41808 | CA |
NPI | 1134192016 |
---|---|
Provider Name | Dr. Joseph C Yang |
First Address | Vienna, VA 22182-2147 |
Second Address | Bethesda, MD 20889-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 04/10/2016 |