Provider Demographics
NPI:1215990445
Name:YANG, MICHAEL C (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:YANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 SUNCAST LN
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9631
Mailing Address - Country:US
Mailing Address - Phone:530-672-1311
Mailing Address - Fax:530-672-1335
Practice Address - Street 1:1208 SUNCAST LN
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9631
Practice Address - Country:US
Practice Address - Phone:530-672-1311
Practice Address - Fax:530-672-1335
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA837802207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A837800Medicaid
CA00A837802Medicare ID - Type Unspecified
CA00A837800Medicaid