Provider Demographics
NPI:1285261248
Name:YANG, BRONTE SOPHY (DO)
Entity type:Individual
Prefix:DR
First Name:BRONTE
Middle Name:SOPHY
Last Name:YANG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 FLORIDA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4445
Mailing Address - Country:US
Mailing Address - Phone:209-576-3528
Mailing Address - Fax:
Practice Address - Street 1:1400 FLORIDA AVE STE 200
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4445
Practice Address - Country:US
Practice Address - Phone:209-576-3528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19844207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine