MEDICARE: YIXUAN CHANG NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	95009221	CA
2	363L00000X	Nurse Practitioner	95009221	CA

General Provider Information

NPI Number	:	1023502598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YIXUAN CHANG NP

Provider Business Mailing Address
First Line	:	5767 W CENTURY BLVD STE 400
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5631
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 UCLA MEDICAL PLZ STE 550
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-6998
Country	:	US
Telephone Number	:	310-794-4955
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2018
Last Update Date	:	06/10/2026

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Directions to “ YIXUAN CHANG NP” Practice Location

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