Provider Demographics
NPI:1962434050
Name:YANG, YENG M (MD)
Entity type:Individual
Prefix:DR
First Name:YENG
Middle Name:M
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 1:8170 33RD AVE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:651-293-8100
Mailing Address - Fax:
Practice Address - Street 1:205 WABASHA ST S
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55107-1805
Practice Address - Country:US
Practice Address - Phone:651-293-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN42791207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1024818OtherPREFERRED ONE
MN1060053OtherAMERICA'S PPO
MN6603915OtherMEDICA UC
MN127880OtherUCARE MN
MNHP30918OtherHEALTHPARTNERS
MN90D53YAOtherBCBS OF MN
MN7225152OtherAETNA INS
MN0401712OtherMEDICA
MN520080600Medicaid
MN110209400Medicare ID - Type UnspecifiedMEDICARE RR
MN110006747Medicare ID - Type UnspecifiedWPS MEDICARE #
MN90D53YAOtherBCBS OF MN