Active NPI
Alisa Fang, PA
- Physician Assistant
- Los Angeles, CA
National Provider Identifier
1972458719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA67894
- Practice address
- 590 N Vermont Ave
Los Angeles, CA 90004-2115 - Phone
- (323) 284-7998
- NPI assigned
- Feb 26, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA67894 | CA | Primary |
Addresses
Primary practice location
590 N Vermont Ave
Los Angeles, CA 90004-2115
Mailing address
1501 Shaffer CT
Brea, CA 92821-2729
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA67894 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1772064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772064000000",
"number": "1972458719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 SHAFFER CT",
"city": "BREA",
"state": "CA",
"postal_code": "928212729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 N VERMONT AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900042115",
"telephone_number": "323-284-7998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANG",
"first_name": "ALISA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-02-26",
"last_updated": "2026-02-26",
"certification_date": "2026-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA67894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.