Healthcare Provider Details

I. General information

NPI: 1861668048
Provider Name (Legal Business Name): ANGEL J YAP M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGEL INDRADJAJA

II. Dates (important events)

Enumeration Date: 05/07/2008
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 NATOMA ST
SAN FRANCISCO CA
94105-3746
US

IV. Provider business mailing address

427 E 17TH ST #785
COSTA MESA CA
92627-4748
US

V. Phone/Fax

Practice location:
  • Phone: 619-648-1247
  • Fax:
Mailing address:
  • Phone: 949-478-4356
  • Fax: 949-276-3187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA107182
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: