Organization Active NPI

Yangdong He Medical Corporation

  • Internal Medicine Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1235620261
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A135621 Issued in CA
Legal business name
YANGDONG HE MEDICAL CORPORATION
Practice address
5411 Duncaster PL
Rancho Cucamonga, CA 91739
Phone
(734) 358-2738
NPI assigned
May 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Yangdong He, MDNPI 1386907038
Title
Owner
Phone
(734) 358-2738

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A135621 CA Primary

Addresses

Primary practice location

5411 Duncaster PL
Rancho Cucamonga, CA 91739

Mailing address

5411 Duncaster PL
Rancho Cucamonga, CA 91739-2603
Phone (734) 358-2738

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180706001200 CA Part B Supplier - Clinic/Group Practice 5092061952 Receives reassigned benefits from 1 practitioner
Practice locations: Rancho Cucamonga, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1235620261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5411 DUNCASTER PL",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917392603",
            "telephone_number": "734-358-2738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5411 DUNCASTER PL",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "91739",
            "telephone_number": "734-358-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YANGDONG HE MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-25",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "HE",
        "authorized_official_first_name": "YANGDONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-358-2738",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A135621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.