Individual provider Active NPI

Anh Dao T Chung, D.O.

  • Family Medicine Physician
  • Torrance, CA
National Provider Identifier
1295787638
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A8282 Issued in CA
Practice address
21311 Madrona Ave
Ste 100-a
Torrance, CA 90503-5970
Phone
(310) 792-4400
Fax
(310) 542-5805
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A8282 CA Primary

Addresses

Primary practice location

21311 Madrona Ave
Ste 100-a
Torrance, CA 90503-5970

Mailing address

21311 Madrona Ave
Ste 100-a
Torrance, CA 90503-5970
Phone (310) 792-4400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address achung196648@oc.providencedirect.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040811000429 CA Practitioner - Family Practice 9537131438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

Glendale, CA 91202

Laguna Niguel, CA 92677

21311 Madrona Ave
Torrance, CA 90503-5970

21501 Avalon Blvd
Suite 100
Carson, CA 90745-2210
Phone (310) 835-6627

Hospital & facility affiliations

  • Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353
  • Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A8282CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute Family Medicine CurrentSince Feb 13, 2018 Accepting new patients
Providence Medical Institute Family Medicine Current Accepting new patients
Providence Medical Institute Family Medicine CurrentSince Feb 13, 2018 Accepting new patients
Gastro Care Institute Past Accepting new patients
Providence Health System Southern California Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

21501 Avalon Blvd
Ste 100
Carson, CA 90745
Phone (310) 835-6627

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

1010 N Sepulveda Blvd
Manhattan Beach, CA 90266
Phone (310) 322-9700

1499 W 1st St
San Pedro, CA 90732
Phone (310) 241-2590

20911 Earl St
Ste 440
Torrance, CA 90503
Phone (310) 419-8585

21311 Madrona Ave
Ste 100A
Torrance, CA 90503
Phone (310) 792-4400

2382 Crenshaw Blvd
Ste 5
Torrance, CA 90501
Phone (310) 618-6200

21311 Madrona Ave
Ste 100
Torrance, CA 90503

20911 Earl St
Ste 400
Torrance, CA 90503
Phone (310) 370-0007

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1295787638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21311 MADRONA AVE",
            "address_2": "STE 100-A",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905035970",
            "telephone_number": "310-792-4400",
            "fax_number": "310-542-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21311 MADRONA AVE",
            "address_2": "STE 100-A",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905035970",
            "telephone_number": "310-792-4400",
            "fax_number": "310-542-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "ANH DAO",
        "middle_name": "T",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A8282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "achung196648@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "21311 Madrona Ave",
            "address_2": "Ste 100-A",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "905035970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.