Individual provider Active NPI

Oi Y. Chung, P.A.,N.P.

  • Physician Assistant
  • Monterey Park, CA
National Provider Identifier
1104085893
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19610 Issued in CA
Practice address
525 N Garfield Ave
Monterey Park, CA 91754-1202
Phone
(626) 573-2222
NPI assigned
Jun 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA19610 CA Primary
Nurse Practitioner 363L00000X NP584426 CA

Addresses

Primary practice location

525 N Garfield Ave
Monterey Park, CA 91754-1202

Mailing address

PO Box 660579
Arcadia, CA 91066-0579
Phone (626) 447-0296

Other practice location 1

2710 Gateway Oaks Dr Ste 150N
Sacramento, CA 95833-3502
Phone (646) 876-8455

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
I20110207000062 CA Practitioner - Physician Assistant 6406915941 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP584426CAMDNurse Practitioner
19610CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michael S. Agron, M.D., Inc. Past Accepting new patients
Glendale Emergency Medical Associates, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: oi.chung.2@22307.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1104085893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660579",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910660579",
            "telephone_number": "626-447-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N GARFIELD AVE",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541202",
            "telephone_number": "626-573-2222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2710 Gateway Oaks Dr Ste 150N",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958333502",
            "country_code": "US",
            "telephone_number": "646-876-8455",
            "fax_number": "914-565-8656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "OI",
        "middle_name": "Y.",
        "credential": "P.A.,N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-06",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19610",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP584426",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

Verify at the official NPI Registry.