NPIMap

Organization Active NPI

Acn Medical Group Inc

  • Internal Medicine Physician
  • Millbrae, CA
National Provider Identifier
1154747020
Registry record updated Jul 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A107327 Issued in CA
Legal business name
ACN MEDICAL GROUP INC
Practice address
423 Broadway
Suite 604
Millbrae, CA 94030-1905
Phone
(650) 732-9721
Fax
(510) 323-4286
NPI assigned
Mar 14, 2014
Last updated
Jul 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2014

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

Authorized official

Name
Andrew NG, MDNPI 1871716910
Title
Owner
Phone
(650) 732-9721

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A107327 CA Primary

Addresses

Primary practice location

423 Broadway
Suite 604
Millbrae, CA 94030-1905

Mailing address

423 Broadway
Suite 604
Millbrae, CA 94030-1905
Phone (650) 732-9721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140702000239 CA Part B Supplier - Clinic/Group Practice 3577788785 Receives reassigned benefits from 3 practitioners
Practice locations: Millbrae, CA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GIGHCA

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1394755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406246400000",
    "number": "1154747020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 BROADWAY",
            "address_2": "SUITE 604",
            "city": "MILLBRAE",
            "state": "CA",
            "postal_code": "940301905",
            "telephone_number": "650-732-9721",
            "fax_number": "510-323-4286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 BROADWAY",
            "address_2": "SUITE 604",
            "city": "MILLBRAE",
            "state": "CA",
            "postal_code": "940301905",
            "telephone_number": "650-732-9721",
            "fax_number": "510-323-4286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACN MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-14",
        "last_updated": "2014-07-25",
        "status": "A",
        "authorized_official_last_name": "NG",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-732-9721",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A107327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millbrae, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.