Healthcare Provider Details

I. General information

NPI: 1417905118
Provider Name (Legal Business Name): KAY YAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 03/23/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2708 E WILLOW ST
SIGNAL HILL CA
90755-2217
US

IV. Provider business mailing address

2708 E WILLOW ST
SIGNAL HILL CA
90755-2217
US

V. Phone/Fax

Practice location:
  • Phone: 562-216-5120
  • Fax: 562-216-5121
Mailing address:
  • Phone: 562-216-5120
  • Fax: 562-216-5121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberG60384
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberG60384
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: