Active NPI
Edwin T Chuong, M.D.
- Internal Medicine Physician
- Diamond Bar, CA
National Provider Identifier
1427231802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A85751
- Practice address
- 1540 Bridgegate Dr
Diamond Bar, CA 91765-3912 - Phone
- (626) 388-2319
- Fax
- (626) 388-2341
- NPI assigned
- Dec 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A85751 | CA | Primary |
Addresses
Primary practice location
1540 Bridgegate Dr
Diamond Bar, CA 91765-3912
Mailing address
1540 Bridgegate Dr
Diamond Bar, CA 91765-3912
Phone (626) 388-2319
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110505000719 | CA | Order and Referring Only - Internal Medicine | 4082899091 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A85751 | CA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261612800000",
"number": "1427231802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1540 BRIDGEGATE DR",
"city": "DIAMOND BAR",
"state": "CA",
"postal_code": "917653912",
"telephone_number": "626-388-2319",
"fax_number": "626-388-2341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1540 BRIDGEGATE DR",
"city": "DIAMOND BAR",
"state": "CA",
"postal_code": "917653912",
"telephone_number": "626-388-2319",
"fax_number": "626-388-2341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUONG",
"first_name": "EDWIN",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-12-09",
"last_updated": "2009-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A85751",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Diamond Bar, CA
- Ashley Chung, DTR
- Beau Michael Chung, D.O.
- Erin Hannah Chung
- Peter Howon Chung, D.D.S.
- Yoon Jee Chung
- Clearwater Care Partners LLC
- Co-Creative Marriage and Family Counseling Inc
- Coast 2 Coast Transportation
- Coast 2 Coast Transportation
- Cogdiversified, a Marriage & Family Counseling Professional Corporation
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.