Organization Active NPI

East Los Angeles ENT Medical Center

  • Otolaryngology/Facial Plastic Surgery Physician
  • San Gabriel, CA
National Provider Identifier
1386750198
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
A83484 Issued in CA
Legal business name
EAST LOS ANGELES ENT MEDICAL CENTER
Practice address
533 W Las Tunas Dr # 202
San Gabriel, CA 91776-1133
Phone
(626) 284-2000
Fax
(626) 284-4300
NPI assigned
Aug 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Authorized official

Name
Dr. Shounan Yao, M.D.NPI 1760480651
Title
President
Phone
(626) 284-2000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YX0905X A83484 CA Primary

Addresses

Primary practice location

533 W Las Tunas Dr # 202
San Gabriel, CA 91776-1133

Mailing address

533 W Las Tunas Dr # 202
San Gabriel, CA 91776-1133
Phone (626) 284-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061113000236 CA Part B Supplier - Clinic/Group Practice 3476551177 Receives reassigned benefits from 1 practitioner
Practice locations: San Gabriel, CA

National Provider Directory

National Provider Directory

Locations

103 N Garfield Ave
Ste A
Alhambra, CA 91801
Phone (626) 284-1000

533 W Las Tunas Dr
Ste 202
San Gabriel, CA 91776
Phone (626) 284-2000

533 W Las Tunas Dr
#202
San Gabriel, CA 91776
Phone (626) 284-2000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1386750198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 W LAS TUNAS DR # 202",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761133",
            "telephone_number": "626-284-2000",
            "fax_number": "626-284-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 W LAS TUNAS DR # 202",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761133",
            "telephone_number": "626-284-2000",
            "fax_number": "626-284-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST LOS ANGELES ENT MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A",
        "authorized_official_last_name": "YAO",
        "authorized_official_first_name": "SHOUNAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-284-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "CA",
            "license": "A83484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.