Healthcare Provider Details

I. General information

NPI: 1942424536
Provider Name (Legal Business Name): CHANGJUN YUE M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 CAMPUS DR
IRVINE CA
92612-1601
US

IV. Provider business mailing address

4 SYCAMORE CRK
IRVINE CA
92603-3429
US

V. Phone/Fax

Practice location:
  • Phone: 949-788-9126
  • Fax:
Mailing address:
  • Phone: 949-387-9645
  • Fax: 949-387-9645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License NumberA71827
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA71827
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: