Provider Demographics
NPI:1356980841
Name:YANG, HSIAO-YI (OD)
Entity type:Individual
Prefix:DR
First Name:HSIAO-YI
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 WAGON WHEEL ST
Mailing Address - Street 2:
Mailing Address - City:PHILLIPS RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91766-7601
Mailing Address - Country:US
Mailing Address - Phone:909-767-3379
Mailing Address - Fax:
Practice Address - Street 1:1065 BREA MALL SPC 2111A
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5718
Practice Address - Country:US
Practice Address - Phone:714-674-5040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-31
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34477TLG152WP0200X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty