Individual
ALISA FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
590 N VERMONT AVE, LOS ANGELES, CA 90004-2115
(323) 284-7998
Mailing address
1501 SHAFFER CT, BREA, CA 92821-2729
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA67894
CA
Other
Enumeration date
02/26/2026
Last updated
02/26/2026
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