Suzanne M Yang, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A69687 Issued in CA

Practice address

78437 Highway 111
La Quinta, CA 92253-2076

Phone

(760) 771-9264

Fax

(760) 771-9271

NPI assigned

Jun 25, 2005

Reactivated

Mar 29, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1119657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1528064300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1542",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922471542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78437 HIGHWAY 111",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922532076",
            "telephone_number": "760-771-9264",
            "fax_number": "760-771-9271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "SUZANNE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-25",
        "last_updated": "2016-04-11",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A69687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A696870",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aidan T Wilson
• Devin Graham Wilson, N.D.
• Kailee Rose Wingrove-Valdez, ACSW
• Wish U Wellness
• Wolfram Dental Corporation
• Arpee F Yeretzian, M.D.
• Yes I Can DME Inc
• Young Song Kim, MD, Inc.
• George Youssef, DDS
• Zadeh Enterprises LLC

• Specialist in La Quinta, CA
• Providers in La Quinta, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.