Individual provider Active NPI

Elaine Ai Lian Gan Yong, MD

  • Pediatrics Physician
  • Irvine, CA
National Provider Identifier
1528138260
Registry record updated Jun 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G077596 Issued in CA
Practice address
16300 Sand Canyon Ave
Suite 811
Irvine, CA 92618
Phone
(949) 753-9000
Fax
(949) 753-5044
NPI assigned
Nov 9, 2006
Last updated
Jun 1, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2017

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 G077596 CA Primary

Addresses

Primary practice location

16300 Sand Canyon Ave
Suite 811
Irvine, CA 92618

Mailing address

16300 Sand Canyon Ave
Suite 811
Irvine, CA 92618
Phone (949) 753-9000

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
I20170713000965 CA Practitioner - Pediatric Medicine 4486923042 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G077596CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hoag Clinic CurrentSince Mar 1, 2019 Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Hoag Hospital Past Accepting new patients

Locations

16100 Sand Canyon Ave
Ste 245
Irvine, CA 92618
Phone (949) 502-3489

510 Superior Ave
Ste 290
Newport Beach, CA 92663
Phone (949) 764-4500

1031 Avenida Pico
Ste 204
San Clemente, CA 92673
Phone (949) 829-5533

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496275200000",
    "number": "1528138260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16300 SAND CANYON AVE",
            "address_2": "SUITE 811",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "92618",
            "telephone_number": "949-753-9000",
            "fax_number": "949-753-5044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16300 SAND CANYON AVE",
            "address_2": "SUITE 811",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "92618",
            "telephone_number": "949-753-9000",
            "fax_number": "949-753-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAN YONG",
        "first_name": "ELAINE",
        "middle_name": "AI LIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2017-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G077596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.