Individual provider Active NPI

Emily Lynn Yang, PA-C

  • Physician Assistant
  • Santa Monica, CA
National Provider Identifier
1356951941
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
59463 Issued in CA
Practice address
1301 20TH St Ste 280
Santa Monica, CA 90404-2053
Phone
(310) 829-6789
NPI assigned
Aug 7, 2020
Last updated
Dec 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 59463 CA Primary
Physician Assistant 363A00000X NU
Medical Physician Assistant 363AM0700X NU
Medical Physician Assistant 363AM0700X CA
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1301 20TH St Ste 280
Santa Monica, CA 90404-2053

Mailing address

1301 20TH St Ste 280
Santa Monica, CA 90404-2053
Phone (310) 829-6789

Other practice location 1

23451 Madison St Ste 290
Torrance, CA 90505-4737
Phone (310) 375-1246 ext. 125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211102001625 CA Practitioner - Physician Assistant 2860880390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Stanford University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12555 W Jefferson Blvd
Los Angeles, CA 90066-7032

1301 20TH St
Santa Monica, CA 90404-2053

2336 Santa Monica Blvd
Suite 204
Santa Monica, CA 90404-2938
Phone (310) 829-6789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
59463CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation Multi-Specialty CurrentSince May 3, 2024 Accepting new patients
El Segundo Endoscopy Center LLC PastSince May 1, 2022 Accepting new patients
Saint John's Health Clinic Multi-Specialty Past Accepting new patients

Locations

1301 20th St
Ste 280
Santa Monica, CA 90404
Phone (310) 829-6789

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1356951941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 20TH ST STE 280",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042053",
            "telephone_number": "310-829-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 20TH ST STE 280",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042053",
            "telephone_number": "310-829-6789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23451 Madison St Ste 290",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905054737",
            "country_code": "US",
            "telephone_number": "310-375-1246 x125",
            "fax_number": "310-375-0981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANG",
        "first_name": "EMILY",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-07",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "59463",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.