Provider Demographics
NPI: | 1215033204 |
---|---|
Name: | YANG, CHUN ESTHER (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | CHUN |
Middle Name: | ESTHER |
Last Name: | YANG |
Suffix: | |
Gender: | F |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | PO BOX 25033 |
Mailing Address - Street 2: | |
Mailing Address - City: | SANTA ANA |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 92799-5033 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 714-347-1000 |
Mailing Address - Fax: | 714-647-1243 |
Practice Address - Street 1: | 681 S PARKER ST STE 150 |
Practice Address - Street 2: | |
Practice Address - City: | ORANGE |
Practice Address - State: | CA |
Practice Address - Zip Code: | 92868-4761 |
Practice Address - Country: | US |
Practice Address - Phone: | 714-744-0900 |
Practice Address - Fax: | 714-744-9232 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-09-16 |
Last Update Date: | 2021-12-02 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | G83219 | 207L00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CA | 00G832190 | Other | BLUE SHIELD ID # |
CA | 00G832190385 | Other | CALOPTIMA ID # |
CA | 00G832190 | Medicaid | |
CA | 050079947 | Other | RAILROAD MEDICARE ID # |
CA | WG83219C | Medicare ID - Type Unspecified | MEDICARE ID # |