Individual
IK JAE YANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1975 BANKSTON DR, TRACY, CA 95304-5923
(510) 825-8934
Mailing address
1975 BANKSTON DR, TRACY, CA 95304-5923
(510) 825-8934
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95167243
CA
Other
Enumeration date
07/11/2024
Last updated
07/11/2024
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