Green Peace Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A33409 Issued in CA

Legal business name

GREEN PEACE MEDICAL GROUP

Practice address

330 W Las Tunas Dr
Suite 3
San Gabriel, CA 91776-1213

Phone

(626) 573-0055

Fax

(626) 573-4087

NPI assigned

Sep 20, 2005

Organization subpart

No

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

Authorized official

Name

Sheng H Chang, MDNPI 1871589903

Title

Owner

Phone

(626) 573-0055

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sheng H Chang, MD

  • Family Medicine Physician
  • San Gabriel, CA
  • NPI 1871589903
  NPD (past) Authorized official
• Andy Chen, MD

  • Internal Medicine Physician
  • Rosemead, CA
  • NPI 1831153659
  NPD (past)
• Yen-PO Liu, D.P.M.

  • Foot Surgery Podiatrist
  • Monterey Park, CA
  • NPI 1033349113
  NPD (past)
• Wendy H Wu, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Monterey Park, CA
  • NPI 1093793184
  NPD (past)

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1003801648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W LAS TUNAS DR",
            "address_2": "SUITE 3",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761213",
            "telephone_number": "626-573-0055",
            "fax_number": "626-573-4087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W LAS TUNAS DR",
            "address_2": "SUITE 3",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761213",
            "telephone_number": "626-573-0055",
            "fax_number": "626-573-4087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN PEACE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-20",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "SHENG",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-573-0055",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A33409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0091430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Home Health Care, LLC
• Sophie W Grace, ACUPUNCTURIST
• Shaun P Grady, MD
• Grant Serenity on Charlotte, Inc.
• Green Health Medical Center Inc
• Green Pine Home Health Care Services, Inc
• Eva Green
• Joshua Gregorious
• Jasmine Florence Grigsby
• Dustin Griner, CRNA

• Family Medicine Physician in San Gabriel, CA
• Providers in San Gabriel, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.