Healthcare Provider Details

I. General information

NPI: 1396308607
Provider Name (Legal Business Name): YANJIA ZHOU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2019
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8905 W POST RD STE 110
LAS VEGAS NV
89148-2429
US

IV. Provider business mailing address

4618 EL CAMINO CABOS DR
LAS VEGAS NV
89147-6055
US

V. Phone/Fax

Practice location:
  • Phone: 918-728-5852
  • Fax:
Mailing address:
  • Phone: 702-475-8608
  • Fax: 702-475-8608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number178951
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number26062
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: