Individual
DR. JACK C YANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4033 3RD AVE, SUITE 420, SAN DIEGO, CA 92103-2117
(619) 548-0450
(888) 900-0442
Mailing address
4077 FIFTH AVE, MER 62, SAN DIEGO, CA 92103-2105
(619) 548-0450
(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
—
00G730020
—
CA
Enumeration date
04/14/2006
Last updated
01/17/2017
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