Provider Demographics
NPI:1538780606
Name:JENNY DACI YANG, PC
Entity type:Organization
Organization Name:JENNY DACI YANG, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:DACI
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-740-3353
Mailing Address - Street 1:200 JOSE FIGUERES AVE STE 180
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1586
Mailing Address - Country:US
Mailing Address - Phone:408-740-3353
Mailing Address - Fax:
Practice Address - Street 1:200 JOSE FIGUERES AVE STE 180
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1586
Practice Address - Country:US
Practice Address - Phone:408-740-3353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty