Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | A67364 | CA |
NPI | 1093873119 |
---|---|
Provider Name | Shu Qing Yang |
First Address | Santa Rosa, CA 95409-3702 |
Second Address | Santa Rosa, CA 95409-3702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 11/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A673640 | (05) | CA |