Individual provider Active NPI

Jonathon Ahn, MD

  • Anesthesiology Physician
  • Fullerton, CA
National Provider Identifier
1053803882
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A164226 Issued in CA
Practice address
101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Phone
(714) 871-3280
NPI assigned
Jun 6, 2018
Last updated
Jun 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A164226 CA Primary

Addresses

Primary practice location

101 E Valencia Mesa Dr
Fullerton, CA 92835-3809

Mailing address

26376 Fowler Dr
Loma Linda, CA 92354-6579

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
I20230628001049 CA Practitioner - Anesthesiology 0840658506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Loma Linda University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied Anesthesia Medical Group IncGroup PAC ID 6103728407, 185 clinicians

Practice addresses (Care Compare)

101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Phone (714) 871-3280

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A164226CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Anesthesia Medical Group Inc Anesthesiology CurrentSince Jun 13, 2023 Accepting new patients

Locations

1124 S Main St
Ste 101
Corona, CA 92882
Phone (951) 737-6363

101 E Valencia Mesa Dr
Fullerton, CA 92835
Phone (714) 446-7505

455 S Main St
Orange, CA 92868
Phone (714) 289-4511

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

999 San Bernardino Rd
Upland, CA 91786
Phone (909) 920-4841

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1053803882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26376 FOWLER DR",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923546579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E VALENCIA MESA DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353809",
            "telephone_number": "714-871-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "JONATHON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2023-06-15",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A164226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.