Provider Demographics
NPI:1154910677
Name:YANG, XENGXUE (PHARM D)
Entity type:Individual
Prefix:
First Name:XENGXUE
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2608 E ASHLAN AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-3207
Mailing Address - Country:US
Mailing Address - Phone:559-492-2162
Mailing Address - Fax:559-492-2166
Practice Address - Street 1:317 W NOBLE AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-2668
Practice Address - Country:US
Practice Address - Phone:559-734-6747
Practice Address - Fax:559-734-7932
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH57671183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist