Provider Demographics
NPI:1235356999
Name:YANG, BENJAMIN KATTLE (MD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:KATTLE
Last Name:YANG
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7117 BROCKTON AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2658
Mailing Address - Country:US
Mailing Address - Phone:951-782-3696
Mailing Address - Fax:951-784-3264
Practice Address - Street 1:7117 BROCKTON AVE.
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3912
Practice Address - Country:US
Practice Address - Phone:951-782-3696
Practice Address - Fax:951-784-3264
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98679208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA98679OtherMEDICAL LICENSE NUMBER
CA1730180415OtherGROUP NPI