Organization Active NPI

Olive Tree Nursing Corporation

  • Internal Medicine Physician
  • Lemon Grove, CA
National Provider Identifier
1194698043
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
OLIVE TREE NURSING CORPORATION
Practice address
7227 Broadway Ste 405
Lemon Grove, CA 91945-1505
Phone
(213) 663-8836
NPI assigned
Sep 26, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Authorized official

Name
Yohan Han Hwang
Title
Ceo
Phone
(213) 663-8836

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

7227 Broadway Ste 405
Lemon Grove, CA 91945-1505

Mailing address

1208 Corte Mendi
Chula Vista, CA 91913-3547
Phone (213) 663-8836

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251106004801 CA Part B Supplier - Clinic/Group Practice 1759871874 Receives reassigned benefits from 6 practitioners
Practice locations: Lemon Grove, CA

National Provider Directory

National Provider Directory

Locations

7227 Broadway
Ste 405
Lemon Grove, CA 91945
Phone (213) 663-8836

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1758844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760486400000",
    "number": "1194698043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 CORTE MENDI",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919133547",
            "telephone_number": "213-663-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7227 BROADWAY STE 405",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919451505",
            "telephone_number": "213-663-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE TREE NURSING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-26",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A",
        "authorized_official_last_name": "HWANG",
        "authorized_official_first_name": "YOHAN",
        "authorized_official_middle_name": "HAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-663-8836"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemon Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.