Provider Demographics
NPI:1487704268
Name:KIM SHIU-CHIN YANG M.D.,INC.
Entity type:Organization
Organization Name:KIM SHIU-CHIN YANG M.D.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:SHIU-CHIN
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-458-0181
Mailing Address - Street 1:207 S SANTA ANITA AVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1146
Mailing Address - Country:US
Mailing Address - Phone:626-458-0181
Mailing Address - Fax:626-458-0183
Practice Address - Street 1:207 S SANTA ANITA AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1146
Practice Address - Country:US
Practice Address - Phone:626-458-0181
Practice Address - Fax:626-458-0183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA408242084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A408240Medicaid
W20651Medicare PIN