Provider Demographics
NPI:1073223863
Name:HARRISON YANG OPTOMETRY
Entity type:Organization
Organization Name:HARRISON YANG OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARRISON
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:858-205-8899
Mailing Address - Street 1:17662 ORANGE TREE LN
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-2315
Mailing Address - Country:US
Mailing Address - Phone:858-205-8899
Mailing Address - Fax:
Practice Address - Street 1:2056 WESTMINSTER MALL
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4947
Practice Address - Country:US
Practice Address - Phone:714-897-0996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center