Provider Demographics
NPI:1902091507
Name:MICHELLE YANG MD PC INC
Entity type:Organization
Organization Name:MICHELLE YANG MD PC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-437-9900
Mailing Address - Street 1:923 NINTH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-6467
Mailing Address - Country:US
Mailing Address - Phone:505-437-9900
Mailing Address - Fax:505-437-5500
Practice Address - Street 1:923 9TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-6467
Practice Address - Country:US
Practice Address - Phone:505-437-9900
Practice Address - Fax:505-437-5500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
800521006Medicare PIN