Individual provider Active NPI

Yan S. Zhao, M.D.

  • Gastroenterology Physician
  • Loma Linda, CA
National Provider Identifier
1891915336
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A80975 Issued in CA
Practice address
11201 Benton St
Loma Linda, CA 92357-1000
Phone
(909) 825-7084
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A80975 CA
Gastroenterology Physician 207RG0100X A80975 CA Primary

Addresses

Primary practice location

11201 Benton St
Loma Linda, CA 92357-1000

Mailing address

56994 File Number
Los Angeles, CA 90074-6994
Phone (909) 558-3111

Other identifiers 1

IdentifierTypeStateIssuer
00A809750MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070917000416 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 0143314591 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A80975CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Nov 1, 2011 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Family Medicine CurrentSince Nov 1, 2011 Accepting new patients
Loma Linda University Physicians Medical Group Inc Internal Medicine Past Accepting new patients
Nebi PC Gastroenterology PastSince May 1, 2026 Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Community Hospital of San Bernardino Past Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients

Locations

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

11370 Anderson St
Ste 3150
Loma Linda, CA 92354
Phone (909) 558-2191

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11370 Anderson St
Ste 3300
Loma Linda, CA 92354
Phone (909) 478-6191

11370 Anderson St
Ste 31503625
Loma Linda, CA 92354
Phone (909) 558-2191

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

27990 Sherman Rd
Sun City, CA 92585
Phone (909) 672-1931

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24495/brand/1/csg/1/fhir/r4
  • Direct secure messaging: yan.zhao.1@24495.direct.athenahealth.com
  • Direct secure messaging: yzhao12499@direct.llu.edu

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1891915336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56994 FILE NUMBER",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900746994",
            "telephone_number": "909-558-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 BENTON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923571000",
            "telephone_number": "909-825-7084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHAO",
        "first_name": "YAN",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A80975",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A80975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A809750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.