Individual provider Active NPI

Lisa Yeung, MS, PA-C

  • Physician Assistant
  • West Covina, CA
National Provider Identifier
1215062526
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17166 Issued in CA
Practice address
1115 S Sunset Ave Ste 200
West Covina, CA 91790-3940
Phone
(626) 732-8390
NPI assigned
Feb 23, 2007
Last updated
Feb 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA17166 CA
Physician Assistant 363A00000X PA17166 CA Primary

Addresses

Primary practice location

1115 S Sunset Ave Ste 200
West Covina, CA 91790-3940

Mailing address

420 W Rowland St
Covina, CA 91723-2943
Phone (626) 331-6411

Other practice location 1

420 W Rowland St
Covina, CA 91723-2943
Phone (626) 331-6411

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
I20080314000468 CA Practitioner - Physician Assistant 1153406129 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emanate Health Medical Care FoundationGroup PAC ID 9830544980, 85 clinicians

Practice addresses (Care Compare)

1115 S Sunset Ave
West Covina, CA 91790-3940

1135 S Sunset Ave
Suite 401
West Covina, CA 91790-3921
Phone (626) 732-8391

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
17166CAMDSpeech-Language Pathologist
PA17166CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Citrus Valley Physician Partners CurrentSince Sep 1, 2023 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jul 1, 2017 Accepting new patients
Emanate Health Medical Group CurrentSince Sep 1, 2023 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

210 W San Bernardino Rd
Covina, CA 91723
Phone (626) 858-8580

420 W Rowland St
Covina, CA 91723
Phone (626) 331-6411

440 W Foothill Blvd
Glendora, CA 91741
Phone (626) 963-9402

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

1115 S Sunset Ave
Ste 200
West Covina, CA 91790
Phone (626) 732-8390

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1215062526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W ROWLAND ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917232943",
            "telephone_number": "626-331-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S SUNSET AVE STE 200",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903940",
            "telephone_number": "626-732-8390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 W Rowland St",
            "address_purpose": "LOCATION",
            "city": "Covina",
            "state": "CA",
            "postal_code": "917232943",
            "country_code": "US",
            "telephone_number": "626-331-6411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YEUNG",
        "first_name": "LISA",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA17166",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.