Active NPI
Taeseob Yang
- Specialist
- South Pasadena, CA
National Provider Identifier
1043408370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 28740
- Practice address
- 1445 Huntington Dr
101
South Pasadena, CA 91030-4553 - Phone
- (626) 441-1611
- NPI assigned
- Oct 11, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 28740 | CA | Primary |
Addresses
Primary practice location
1445 Huntington Dr
101
South Pasadena, CA 91030-4553
Mailing address
1445 Huntington Dr.
101
South Pasadena, CA 91030-5468
Phone (626) 441-1611
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28740 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192060800000",
"number": "1043408370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1445 HUNTINGTON DR.",
"address_2": "101",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910305468",
"telephone_number": "626-441-1611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1445 HUNTINGTON DR",
"address_2": "101",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910304553",
"telephone_number": "626-441-1611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YANG",
"first_name": "TAESEOB",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-11",
"last_updated": "2007-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "28740",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.