Provider Demographics
NPI:1851044143
Name:FAN, ZHAOYANG (PHD)
Entity Type:Individual
Prefix:
First Name:ZHAOYANG
Middle Name:
Last Name:FAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2337 PALOS VERDES DR W APT 7
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-2763
Mailing Address - Country:US
Mailing Address - Phone:310-425-9814
Mailing Address - Fax:
Practice Address - Street 1:1975 ZONAL AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-5601
Practice Address - Country:US
Practice Address - Phone:323-442-8186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics