Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 34.014662 | OH |
N | 207Q00000X | Family Doctor | 34.014662 | OH |
NPI | 1144681560 |
---|---|
Provider Name | Zhan Tao Yang |
First Address | Beachwood, OH 44122-5522 |
Second Address | Warrensville Heights, OH 44122-7024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2016 |
Last Update Date | 09/07/2020 |