Organization
JACK C YANG MD A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK C YANG (PRESIDENT)
(619) 255-1440
Entity
Organization
Contact information
Practice address
4033 3RD AVE, SUITE 204, SAN DIEGO, CA 92103-2117
(619) 255-1440
(888) 900-0442
Mailing address
4077 5TH AVE, MER 62, SAN DIEGO, CA 92103-2105
(619) 255-1440
(888) 900-0442
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
G73002
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G730022
—
CA
Enumeration date
04/17/2006
Last updated
08/14/2017
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