MEDICARE: YEN ANKER 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	363L00000X	Nurse Practitioner	NP95003992	CA

General Provider Information

NPI Number	:	1104273309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YEN ANKER NP

Provider Business Mailing Address
First Line	:	40 MANZANILLO
Second Line	:
City	:	LAKE FOREST
State	:	CA
Zip	:	92630-1442
Country	:	US
Telephone Number	:	949-468-9663
Fax Number	:

Provider Business Practice Location Address
First Line	:	24552 PACIFIC PARK DR
Second Line	:
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656
Country	:	US
Telephone Number	:	949-565-2377
Fax Number	:

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

Provider Enumeration Date	:	05/17/2016
Last Update Date	:	12/03/2025

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