Abc Medical Clinic, Inc.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A63361 Issued in CA

Legal business name

ABC MEDICAL CLINIC, INC.

Practice address

500 N Garfield Ave
Suite 110a
Monterey Park, CA 91754-1242

Phone

(626) 282-4840

Fax

(626) 288-4820

NPI assigned

Jul 16, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jian N. Ye, M.D.NPI 1265458228

Title

Owner

Phone

(626) 288-4840

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Jian N. Ye, M.D.

  • Dermatology Physician
  • Monterey Park, CA
  • NPI 1265458228
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417392000000",
    "number": "1013934082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N GARFIELD AVE",
            "address_2": "SUITE 110A",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541242",
            "telephone_number": "626-282-4840",
            "fax_number": "626-288-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N GARFIELD AVE",
            "address_2": "SUITE 110A",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541242",
            "telephone_number": "626-282-4840",
            "fax_number": "626-288-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2014-12-01",
        "status": "A",
        "authorized_official_last_name": "YE",
        "authorized_official_first_name": "JIAN",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-288-4840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A63361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A633640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Monterey Park, CA
• Providers in Monterey Park, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.