Individual provider Active NPI

Chan Myat Aung, M.D.

  • Internal Medicine Physician
  • Pomona, CA
National Provider Identifier
1376949230
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A140828 Issued in CA
Practice address
790 E Bonita Ave
2ND Floor
Pomona, CA 91767-1906
Phone
(909) 447-8585
Fax
(909) 447-8593
NPI assigned
Nov 5, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X A140828 CA Primary

Addresses

Primary practice location

790 E Bonita Ave
2ND Floor
Pomona, CA 91767-1906

Mailing address

840 Towne Center Dr
Pomona, CA 91767-5900
Phone (909) 398-1550

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address caung1373510@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
I20170329000958 CA Practitioner - Internal Medicine 7810272192 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

17095 Main St
Hesperia, CA 92345-6004
Phone (760) 241-6666

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A140828CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chaparral Medical Group Inc. CurrentSince Feb 11, 2017 Accepting new patients
Providence Medical Foundation CurrentSince Dec 30, 2019 Accepting new patients
Chaparral Medical Group, Inc. Current Accepting new patients
Chaparral Medical Group, Inc. Internal Medicine CurrentSince Feb 11, 2017 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Dec 30, 2019 Accepting new patients
Providence Medical Foundation Past Accepting new patients
St. Mary Medical Center Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

19333 Bear Valley Rd
Ste 106
Apple Valley, CA 92308
Phone (760) 240-5505

17095 Main St
Hesperia, CA 92345
Phone (760) 948-6606

1801 W Olympic Blvd
Pasadena, CA 91199

1866 N Orange Grove Ave
Ste 202
Pomona, CA 91767
Phone (909) 623-8796

790 E Bonita Ave
Fl 2
Pomona, CA 91767
Phone (909) 447-8585

840 Towne Center Dr
Pomona, CA 91767

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

12550 Hesperia Rd
Ste 100
Victorville, CA 92395

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: caung1373510@oc.providencedirect.org

Organizations & group practices 8

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 1

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": "1415145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1376949230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 TOWNE CENTER DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675900",
            "telephone_number": "909-398-1550",
            "fax_number": "909-398-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 E BONITA AVE",
            "address_2": "2ND FLOOR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671906",
            "telephone_number": "909-447-8585",
            "fax_number": "909-447-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUNG",
        "first_name": "CHAN",
        "middle_name": "MYAT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-05",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A140828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "caung1373510@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "17095 Main St",
            "city": "Hesperia",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923456004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.