Individual provider Active NPI

Allen Jack Yiu

  • Pediatrics Physician
  • Orange, CA
National Provider Identifier
1508325812
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A178493 Issued in CA
Practice address
505 S Main St Ste 525
Orange, CA 92868-4553
Phone
(714) 456-5631
Fax
(714) 285-0389
NPI assigned
Mar 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A178493 CA Primary

Addresses

Primary practice location

505 S Main St Ste 525
Orange, CA 92868-4553

Mailing address

1201 W la Veta Ave
Orange, CA 92868-4203
Phone (714) 509-4373

Other practice location 1

1201 W La Veta Ave
Orange, CA 92868-4203
Phone (714) 509-4373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20240703000745 DC Practitioner - Pediatric Medicine 6406266964 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A178493CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital CurrentSince Jun 4, 2024 Accepting new patients
Children'S Hospital Pediatrics CurrentSince Jun 4, 2024 Accepting new patients
Children'S Hospital Current Accepting new patients
Pediatric Subspecialty Faculty, Inc. Pediatrics Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

641 S St NW
Washington, DC 20001
Phone (202) 476-2123

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1508325812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "714-509-4373",
            "fax_number": "714-509-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S MAIN ST STE 525",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684553",
            "telephone_number": "714-456-5631",
            "fax_number": "714-285-0389"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 W La Veta Ave",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928684203",
            "country_code": "US",
            "telephone_number": "714-509-4373",
            "fax_number": "714-509-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YIU",
        "first_name": "ALLEN",
        "middle_name": "JACK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-16",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A178493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.