Individual provider Active NPI

Kwun Man Simon Yu, DC

  • Chiropractor
  • West Covina, CA
National Provider Identifier
1245094150
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC36879 Issued in CA
Practice address
855 N Lark Ellen Ave Ste M
West Covina, CA 91791-1099
Phone
(626) 878-5233
Fax
(626) 779-9225
NPI assigned
Feb 12, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC36879 CA Primary

Addresses

Primary practice location

855 N Lark Ellen Ave Ste M
West Covina, CA 91791-1099

Mailing address

855 N Lark Ellen Ave Ste M
West Covina, CA 91791-1099
Phone (626) 878-5233

Other practice location 1

33 E Valley Blvd Ste 215
Alhambra, CA 91801-5168
Phone (626) 878-5233

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250521001077 CA Practitioner - Chiropractic 6709305907 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

855 N Lark Ellen Ave
West Covina, CA 91791-1099
Phone (626) 878-5233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC36879CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Kwun Man Simon Yu Chiropractic Apc Chiropractor CurrentSince Apr 1, 2025 Accepting new patients
Sherman Oaks Integrated Medical Group, Inc. CurrentSince Jul 12, 2025 Accepting new patients

Locations

33 E Valley Blvd
Ste 215
Alhambra, CA 91801
Phone (626) 878-5233

4835 Van Nuys Blvd
Ste 105
Sherman Oaks, CA 91403
Phone (818) 786-5985

855 N Lark Ellen Ave
Ste M
West Covina, CA 91791
Phone (626) 878-5233

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1245094150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 N LARK ELLEN AVE STE M",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911099",
            "telephone_number": "626-878-5233",
            "fax_number": "626-779-9225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 N LARK ELLEN AVE STE M",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911099",
            "telephone_number": "626-878-5233",
            "fax_number": "626-779-9225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 E Valley Blvd Ste 215",
            "address_purpose": "LOCATION",
            "city": "Alhambra",
            "state": "CA",
            "postal_code": "918015168",
            "country_code": "US",
            "telephone_number": "626-878-5233",
            "fax_number": "626-779-9225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YU",
        "first_name": "KWUN MAN SIMON",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-12",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC36879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.