Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 62188 | CA |
NPI | 1003254137 |
---|---|
Provider Name | Joseph Yang |
First Address | San Francisco, CA 94127-1303 |
Second Address | San Francisco, CA 94127-1303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2013 |
Last Update Date | 24/06/2019 |