MEDICARE: MR. CHANGGAO YANG MD

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	A062281	CA
2	207ZD0900X	Dermatopathology (Pathology) Physician	A062281	CA
3	207ZP0007X	Molecular Genetic Pathology (Pathology) Physician	A062281	CA
4	207ZH0000X	Hematology (Pathology) Physician	A062281	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	05D1012129	OTHER		CLIA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366435638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHANGGAO YANG MD

Provider Business Mailing Address
First Line	:	3030 OLD RANCH PKWY
Second Line	:	SUITE 430
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-2765
Country	:	US
Telephone Number	:	562-799-8900
Fax Number	:	562-799-8901

Provider Business Practice Location Address
First Line	:	3030 OLD RANCH PKWY
Second Line	:	SUITE 430
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-2765
Country	:	US
Telephone Number	:	562-799-8900
Fax Number	:	562-799-8901

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

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	01/10/2026

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Directions to “ MR. CHANGGAO YANG MD” Practice Location

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