Provider Demographics
NPI:1407865959
Name:YANG, TED P (MD)
Entity type:Individual
Prefix:MR
First Name:TED
Middle Name:P
Last Name:YANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4305 TORRANCE BLVD STE 505
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4496
Mailing Address - Country:US
Mailing Address - Phone:310-355-8488
Mailing Address - Fax:949-276-3213
Practice Address - Street 1:4305 TORRANCE BLVD STE 505
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4496
Practice Address - Country:US
Practice Address - Phone:310-355-8488
Practice Address - Fax:949-276-3213
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA63676207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA63676CMedicare ID - Type Unspecified
CAWA637676GMedicare ID - Type Unspecified
CAWA63676EMedicare ID - Type Unspecified
CAWA63676FMedicare ID - Type Unspecified
CAWA63676BMedicare ID - Type Unspecified
CAWA63676DMedicare ID - Type Unspecified
CAF00860Medicare UPIN