Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 24098 | CA |
NPI | 1053928986 |
---|---|
Provider Name | Xueyan Yang |
First Address | San Diego, CA 92130-1305 |
Second Address | San Diego, CA 92130-1305 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2020 |
Last Update Date | 24/09/2020 |