Individual provider Active NPI

Yichun Michelle Fang, RN

  • General Practice Registered Nurse
  • Santa Monica, CA
National Provider Identifier
1225274624
Registry record updated Jan 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
18462 Issued in CA
Practice address
2716 Ocean Park Blvd
Suite 3082
Santa Monica, CA 90405-5207
Phone
(310) 345-3818
Fax
(310) 314-2414
NPI assigned
Jan 6, 2009
Last updated
Jan 7, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 680110 CA
General Practice Registered Nurse 163WG0000X 18462 CA Primary

Addresses

Primary practice location

2716 Ocean Park Blvd
Suite 3082
Santa Monica, CA 90405-5207

Mailing address

2716 Ocean Park Blvd
Suite 3082
Santa Monica, CA 90405-5207
Phone (310) 345-3818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
680110CAMDGeneral Practice Registered Nurse
18462CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Neurography Institute Global Consulting Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231286400000",
    "number": "1225274624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 OCEAN PARK BLVD",
            "address_2": "SUITE 3082",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904055207",
            "telephone_number": "310-345-3818",
            "fax_number": "310-314-2414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2716 OCEAN PARK BLVD",
            "address_2": "SUITE 3082",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904055207",
            "telephone_number": "310-345-3818",
            "fax_number": "310-314-2414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANG",
        "first_name": "YICHUN",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-06",
        "last_updated": "2009-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "680110",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "18462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.