Individual provider Active NPI

Tiffany Sheauchi Pan, M.D.

  • Internal Medicine Physician
  • El Monte, CA
National Provider Identifier
1417489154
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A157554 Issued in CA
Practice address
10953 Ramona Blvd
El Monte, CA 91731-2629
Phone
(626) 434-2500
NPI assigned
Mar 31, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A157554 CA Primary
Pediatrics Physician 208000000X A157554 CA

Addresses

Primary practice location

10953 Ramona Blvd
El Monte, CA 91731-2629

Mailing address

10953 Ramona Blvd
El Monte, CA 91731-2629

Other practice location 1

1200 North State Street, CT
A7D
Los Angeles, CA 90033
Phone (323) 409-1000

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
I20221121001355 CA Practitioner - Internal Medicine 0345659629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Southern California Keck School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Los AngelesGroup PAC ID 1850296534, 395 clinicians

Practice addresses (Care Compare)

10953 Ramona Blvd
El Monte, CA 91731-2629
Phone (626) 434-2800

Hospital & facility affiliations

  • Los Angeles General Medical Center Hospital, Los Angeles, CA, CCN 050373
  • Lac/Rancho Los Amigos National Rehabilitation Ctr Hospital, Downey, CA, CCN 050717

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A157554CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Aug 9, 2022 Accepting new patients
County of Los Angeles CurrentSince Aug 9, 2022 Accepting new patients
County of Los Angeles Current Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

10953 Ramona Blvd
Rm 213
El Monte, CA 91731

10953 Ramona Blvd
El Monte, CA 91731
Phone (626) 434-2500

1200 N State St
#A7D
Los Angeles, CA 90089
Phone (323) 226-7556

Organizations & group practices 3

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": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1417489154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10953 RAMONA BLVD",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917312629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10953 RAMONA BLVD",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917312629",
            "telephone_number": "626-434-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 North State Street, CT",
            "address_2": "A7D",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90033",
            "country_code": "US",
            "telephone_number": "323-409-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAN",
        "first_name": "TIFFANY",
        "middle_name": "SHEAUCHI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-31",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A157554",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A157554",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Monte, CA

Sources for this page

Verify at the official NPI Registry.