Individual
DR. MICHAEL ISHU YANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
392 TESCONI CT, SANTA ROSA, CA 95401-4653
(707) 623-9803
(707) 843-3257
Mailing address
392 TESCONI CT, SANTA ROSA, CA 95401-4653
(707) 623-9803
(707) 843-3257
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A112702
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EV430X
MEDICARE PTAN
CA
Enumeration date
10/29/2008
Last updated
04/15/2018
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