Individual provider Active NPI

Susan Jin Yoon, D.O.

  • Diagnostic Radiology Physician
  • Los Angeles, CA
National Provider Identifier
1467832261
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
20A16895 Issued in CA
Practice address
1500 San Pablo St FL 2
Los Angeles, CA 90033-5313
Phone
(323) 442-8541
NPI assigned
Jun 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 20A16895 CA Primary

Addresses

Primary practice location

1500 San Pablo St FL 2
Los Angeles, CA 90033-5313

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-8541

Other practice location 1

5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-7378

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
I20190826000749 CA Practitioner - Diagnostic Radiology 6204164536 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Phone 71499230001805

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A16895CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Jun 1, 2019 Accepting new patients
St Jude Radiology Medical Group Inc Diagnostic Radiology CurrentSince Feb 3, 2020 Accepting new patients
Usc Care Medical Group, Inc Diagnostic Radiology CurrentSince Jun 1, 2019 Accepting new patients
North Oc Imaging JV, LLC CurrentSince Dec 9, 2021 Accepting new patients
North Oc Imaging JV, LLC CurrentSince Jan 12, 2022 Accepting new patients
St Jude Hospital Inc Past Accepting new patients

Locations

5630 E Santa Ana Canyon Rd
Anaheim, CA 92807
Phone (714) 257-6170

8078 E Santa Ana Canyon Rd
Anaheim, CA 92808
Phone (714) 974-2900

955 W Imperial Hwy
Brea, CA 92821
Phone (714) 449-6900

1514 Valley Vista Dr
Diamond Bar, CA 91765
Phone (909) 560-1144

2151 N Harbor Blvd
Ste 3100
Fullerton, CA 92835
Phone (530) 999-2533

2151 N Harbor Blvd
Ste 2100
Fullerton, CA 92835
Phone (714) 446-7181

2151 N Harbor Blvd
Ste 1400
Fullerton, CA 92835
Phone (417) 446-5600

1835 Sunny Crest Dr
Fullerton, CA 92835
Phone (714) 446-5101

100 E Valencia Mesa Dr
Ste 108
Fullerton, CA 92835

2251 N Harbor Blvd
Fullerton, CA 92835
Phone (714) 449-6230

2141 N Harbor Blvd
Ste 16000
Fullerton, CA 92835
Phone (714) 446-5600

101 E Valencia Mesa Dr
Fullerton, CA 92835
Phone (714) 446-7505

731 N Beach Blvd
Ste 175
La Habra, CA 90631
Phone (562) 697-6030

1500 San Pablo St
Fl 2
Los Angeles, CA 90033
Phone (323) 442-8541

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

4300 Rose Dr
Yorba Linda, CA 92886
Phone (714) 528-4211

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": "1433462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1467832261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-8541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SAN PABLO ST FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-442-8541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5501 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413018",
            "country_code": "US",
            "telephone_number": "215-456-7378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOON",
        "first_name": "SUSAN",
        "middle_name": "JIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-05",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "20A16895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.