Individual provider Active NPI

Julie Eunjeong Min, N.P.

  • Gerontology Nurse Practitioner
  • Gardena, CA
National Provider Identifier
1154399566
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN 517212 NP 12611 Issued in CA
Practice address
1251 W Redondo Beach Blvd
3Rd Floor
Gardena, CA 90247-3456
Phone
(310) 851-4705
Fax
(310) 851-4719
NPI assigned
Mar 10, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN 517212 NP 12611 CA Primary

Addresses

Primary practice location

1251 W Redondo Beach Blvd
3Rd Floor
Gardena, CA 90247-3456

Mailing address

2846 S Carolina St
San Pedro, CA 90731-6618
Phone (310) 833-1257

Other names 1

  • Eunjeong Min Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20180320001076 WA Order and Referring Only - Nurse Practitioner 8325300957

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN 517212 NP 12611CAMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1154399566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2846 S CAROLINA ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907316618",
            "telephone_number": "310-833-1257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 W REDONDO BEACH BLVD",
            "address_2": "3RD FLOOR",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473456",
            "telephone_number": "310-851-4705",
            "fax_number": "310-851-4719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIN",
        "first_name": "JULIE",
        "middle_name": "EUNJEONG",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "RN 517212 NP 12611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EUNJEONG",
            "last_name": "MIN",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.