Healthcare Provider Details

I. General information

NPI: 1154282333
Provider Name (Legal Business Name): ANGELA YI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2025
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 WILSHIRE BLVD STE 530
LOS ANGELES CA
90017-5733
US

IV. Provider business mailing address

1245 WILSHIRE BLVD STE 530
LOS ANGELES CA
90017-5733
US

V. Phone/Fax

Practice location:
  • Phone: 213-977-4156
  • Fax: 213-562-9672
Mailing address:
  • Phone: 213-977-4156
  • Fax: 213-562-9672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberNP95033730
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: