Individual provider Active NPI

Jane S Gu, MD

  • Pediatrics Physician
  • Hacienda Heights, CA
National Provider Identifier
1023124096
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A37925 Issued in CA
Practice address
1850 S Azusa Ave
Suite 205
Hacienda Heights, CA 91745
Phone
(626) 964-2880
Fax
(626) 964-2834
NPI assigned
Aug 22, 2006
Last updated
Nov 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A37925 CA Primary

Addresses

Primary practice location

1850 S Azusa Ave
Suite 205
Hacienda Heights, CA 91745

Mailing address

1850 S Azusa Ave
Suite 205
Hacienda Heights, CA 91745
Phone (626) 964-2880

Other identifiers 1

IdentifierTypeStateIssuer
00A379250MedicaidCA

Other names 1

  • Mrs. Shiow-Jane Gu Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110210000251 CA Practitioner - Pediatric Medicine 7416137336 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A37925CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colima Medical Clinic PC Pediatrics CurrentSince Nov 9, 2010 Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Ahmc Whittier Hospital Medical Center LP Past Accepting new patients

Locations

1850 S Azusa Ave
Ste 205
Hacienda Hts, CA 91745
Phone (626) 964-2880

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1023124096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 S AZUSA AVE",
            "address_2": "SUITE 205",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "91745",
            "telephone_number": "626-964-2880",
            "fax_number": "626-964-2834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 S AZUSA AVE",
            "address_2": "SUITE 205",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "91745",
            "telephone_number": "626-964-2880",
            "fax_number": "626-964-2834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GU",
        "first_name": "JANE",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A37925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A379250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIOW-JANE",
            "last_name": "GU",
            "prefix": "MRS.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hacienda Heights, CA

Sources for this page

Verify at the official NPI Registry.