Basic Information
| Provider Information | |||||||||
| NPI: | 1992359384 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YI | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | XIAYANG LI | ||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5550 GROSVENOR BLVD APT 250 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900667314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9093629028 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 28901 S WESTERN AVE STE 135 | ||||||||
| Address2: | |||||||||
| City: | RANCHO PALOS VERDES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902750824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3107502470 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2019 | ||||||||
| LastUpdateDate: | 07/24/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 104045 | CA | Y | Dental Providers | Dentist | General Practice |
No ID Information.