Provider Demographics
NPI:1992926281
Name:YANG, CHARLIE C (MD)
Entity type:Individual
Prefix:
First Name:CHARLIE
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 1:2535 S DOWNING ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5847
Mailing Address - Country:US
Mailing Address - Phone:720-524-1367
Mailing Address - Fax:720-524-1422
Practice Address - Street 1:2535 S DOWNING ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5847
Practice Address - Country:US
Practice Address - Phone:720-524-1367
Practice Address - Fax:720-524-1422
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR-44554207XS0114X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODR-44554OtherDEPT OF REGULATORY AGENCIES
CODR-44554OtherDEPT OF REGULATORY AGENCIES
NC2071145Medicare PIN
COBY9759082OtherDEA