Individual provider Active NPI

Yeong K Ahn, M.D.

  • Specialist
  • Los Angeles, CA
National Provider Identifier
1073504031
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A45633 Issued in CA
Practice address
1300 N Vermont Ave
100
Los Angeles, CA 90027-6005
Phone
(323) 457-4350
Fax
(323) 913-4351
NPI assigned
Oct 31, 2005
Last updated
Dec 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A45633 CA Primary

Addresses

Primary practice location

1300 N Vermont Ave
100
Los Angeles, CA 90027-6005

Mailing address

1300 N Vermont Ave
# 600
Los Angeles, CA 90027-6098
Phone (213) 457-4350

Other identifiers 1

IdentifierTypeStateIssuer
00A456330MedicaidCA

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
I20070111000641 CA Practitioner - General Surgery 5294735478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2200 W 3Rd St
Suite 120B
Los Angeles, CA 90057-5902
Phone (213) 484-7310

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Mastectomy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ahn Medical Group, Inc Specialist CurrentSince Sep 1, 1997 Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients
Cha Hollywood Medical Center, LP Past Accepting new patients

Locations

1300 N Vermont Ave
#100
Los Angeles, CA 90027
Phone (323) 457-4350

1300 N Vermont Ave
#600
Los Angeles, CA 90027
Phone (213) 484-8446

1300 N Vermont Ave
Ste 100
Los Angeles, CA 90027
Phone (323) 913-4300

1300 N Vermont Ave
Ste 600
Los Angeles, CA 90027
Phone (323) 665-5600

2200 W 3rd St
Ste 120B
Los Angeles, CA 90057
Phone (213) 484-7288

3663 W 6th St
Ste 108
Los Angeles, CA 90020
Phone (213) 382-6525

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.

Hospital & facility affiliations 1

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1073504031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N VERMONT AVE",
            "address_2": "# 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276098",
            "telephone_number": "213-457-4350",
            "fax_number": "213-913-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N VERMONT AVE",
            "address_2": "100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276005",
            "telephone_number": "323-457-4350",
            "fax_number": "323-913-4351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "YEONG",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A45633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A456330",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.