Individual provider Active NPI

Katherine Vu, PA-C

  • Physician Assistant
  • Long Beach, CA
National Provider Identifier
1164245502
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA65285 Issued in CA
Practice address
3530 Atlantic Ave Ste 108
Long Beach, CA 90807-4569
Phone
(562) 988-8818
NPI assigned
Nov 4, 2024
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA65285 CA Primary

Addresses

Primary practice location

3530 Atlantic Ave Ste 108
Long Beach, CA 90807-4569

Mailing address

4615 Durfee Ave
El Monte, CA 91732-1723
Phone (626) 548-9915

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
I20250512001626 CA Practitioner - Physician Assistant 9830616945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Midwestern University, Chicago College of Osteopathic Med, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sinu-Clear IncGroup PAC ID 6507950367, 5 clinicians

Practice addresses (Care Compare)

1550 N Park Ave
Pomona, CA 91768-1834
Phone (909) 623-0791

Little Sisters of the Poor
2100 South Wester Avenue
San Pedro, CA 90732-4331
Phone (310) 548-0625

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA65285CAMDPhysician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1164245502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4615 DURFEE AVE",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917321723",
            "telephone_number": "626-548-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 ATLANTIC AVE STE 108",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908074569",
            "telephone_number": "562-988-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VU",
        "first_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.