Individual provider Active NPI

Annie Jia, DO

  • Family Medicine Physician
  • Monterey Park, CA
National Provider Identifier
1104453372
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A20766 Issued in CA
Practice address
525 N Garfield Ave
Monterey Park, CA 91754-1202
Phone
(818) 839-5200
NPI assigned
Mar 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 20A20766 CA Primary

Addresses

Primary practice location

525 N Garfield Ave
Monterey Park, CA 91754-1202

Mailing address

1680 S Garfield Ave Ste 204
Alhambra, CA 91801-5413
Phone (818) 839-5200

Other practice location 1

18406 Roscoe Blvd
Northridge, CA 91325-4107
Phone (818) 993-4054

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
I20231030002892 CA Practitioner - Family Practice 1254787088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apollomed Hospitalists a Medical Corporation 31 clinicians

Practice addresses (Care Compare)

525 N Garfield Ave
Monterey Park, CA 91754-1202
Phone (818) 839-5200

Hospital & facility affiliations

  • Alhambra Hospital Medical Center Hospital, Alhambra, CA, CCN 050281
  • Garfield Medical Center Hospital, Monterey Park, CA, CCN 050737
  • San Gabriel Valley Medical Center Hospital, San Gabriel, CA, CCN 050132
  • Monterey Park Hospital Hospital, Monterey Park, CA, CCN 050736
  • Sunny Village Care Center Nursing home, Alhambra, CA, CCN 055203

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A20766CAMDFamily Medicine Physician
20766CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Astrana Care Hospitalists, a Medical Corporation Single Specialty CurrentSince Sep 18, 2023 Accepting new patients

Locations

1680 S Garfield Ave
Ste 204
Alhambra, CA 91801
Phone (818) 839-5100

525 N Garfield Ave
Monterey Park, CA 91754
Phone (626) 573-2222

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1104453372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 S GARFIELD AVE STE 204",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918015413",
            "telephone_number": "818-839-5200"
        },
        {
            "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": "818-839-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18406 Roscoe Blvd",
            "address_purpose": "LOCATION",
            "city": "Northridge",
            "state": "CA",
            "postal_code": "913254107",
            "country_code": "US",
            "telephone_number": "818-993-4054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIA",
        "first_name": "ANNIE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A20766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

Verify at the official NPI Registry.