Edward Tai Chiang, DO
Individual provider Active NPI Family Medicine Physician · Pasadena, CA
NPI 1104876481 · NPPES record last updated Oct 16, 2021
Key facts
- NPI
- 1104876481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 20A8520 (CA)
- Practice address
- 600 S Lake Ave
Suite 105
Pasadena, CA 91106-3955 - Phone
- (310) 872-8416
- NPI assigned
- May 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- At Still University of Health Sciences, College of Osteo Med, Kirksville, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southern California Permanente Medical Group
Practice addresses (Care Compare)
1011 Balwin Park Blvd
Baldwin Park, CA 91706-5806
Phone (626) 851-1011
1255 W Arrow Hwy
San Dimas, CA 91773-2340
Phone (909) 394-2526
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041118000284 | CA | Practitioner - Family Practice |
8123082237 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Aliso Viejo Family Medicine P C | Family Medicine | Past |
Accepting new patients |
| Seong M. Yoo, DPM Medical Corporation | Family Medicine | Past | Accepting new patients |
Locations
9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910
6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000
4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784
393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914
10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000
1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20A8520 | CA | Yes |
Addresses
Primary practice location
600 S Lake Ave
Suite 105
Pasadena, CA 91106-3955
Mailing address
600 S Lake Ave
Suite 105
Pasadena, CA 91106-3955
Phone (310) 872-8416
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Other providers in Pasadena, CA
- CHI L. Cheng, Et Al
- Grace Tran CHI
- Ming-Fu CHI
- Susan CHI
- Brandon Chia
- Lisa N Chiang
- Valeria Paola Chichiri
- Mario Chico
- Caroline Chien
- Norman T Chien
All providers in Pasadena, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.