Active NPI
Peter J. Yang, M.D.
- Diagnostic Radiology Physician
- La Mesa, CA
National Provider Identifier
1679529564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- G57748
- Practice address
- 8881 Fletcher Parkway #102
La Mesa, CA 91942 - Phone
- (619) 461-1830
- Fax
- (619) 797-1484
- NPI assigned
- May 25, 2006
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | G57748 | CA | Primary |
Addresses
Primary practice location
8881 Fletcher Parkway #102
La Mesa, CA 91942
Mailing address
7777 Alvarado Rd #108
La Mesa, CA 91942
Phone (619) 460-2770
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G577480 | Medicaid | CA | |
| 300015056 | Other | CA | RAILROAD MEDICARE PIN |
| 00G577480 | Other | CA | BLUE SHIELD PIN |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G57748 | CA | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297900800000",
"number": "1679529564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7777 ALVARADO RD #108",
"city": "LA MESA",
"state": "CA",
"postal_code": "91942",
"telephone_number": "619-460-2770",
"fax_number": "619-460-2774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8881 FLETCHER PARKWAY #102",
"city": "LA MESA",
"state": "CA",
"postal_code": "91942",
"telephone_number": "619-461-1830",
"fax_number": "619-797-1484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YANG",
"first_name": "PETER",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-25",
"last_updated": "2011-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "G57748",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G577480",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PIN",
"identifier": "300015056",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD PIN",
"identifier": "00G577480",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in La Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.