Individual provider Active NPI

Lisa Chhin

  • Family Nurse Practitioner
  • Bellflower, CA
National Provider Identifier
1083223242
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95013793 Issued in CA
Practice address
10320 Stonebank St
Bellflower, CA 90706-6831
Phone
(562) 440-5470
NPI assigned
Jul 23, 2020
Last updated
Aug 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95013793 CA Primary

Addresses

Primary practice location

10320 Stonebank St
Bellflower, CA 90706-6831

Mailing address

921 Pacific Coast Hwy
Seal Beach, CA 90740-6244
Phone (562) 598-0473

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201022004236 CA Practitioner - Nurse Practitioner 2466872890 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1360 E Anaheim St
Suite 101
Long Beach, CA 90813-5514

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95013793CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic Medical Group of California Inc Single Specialty CurrentSince May 1, 2020 Accepting new patients
Community Medical Wellness Centers USA Single Specialty CurrentSince Nov 7, 2024 Accepting new patients
Community Medical Wellness Centers USA CurrentSince Nov 7, 2024 Accepting new patients

Locations

1360 E Anaheim St
Ste 101
Long Beach, CA 90813
Phone (562) 270-0324

2514 Berryessa Rd
San Jose, CA 95132
Phone (408) 272-1431

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": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1083223242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 PACIFIC COAST HWY",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907406244",
            "telephone_number": "562-598-0473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10320 STONEBANK ST",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907066831",
            "telephone_number": "562-440-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHHIN",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellflower, CA

Sources for this page

Verify at the official NPI Registry.