Individual provider Active NPI

Lilian Fung

  • Student in an Organized Health Care Education/Training Program
  • Los Angeles, CA
National Provider Identifier
1548840895
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1200 N State Street Clinic Tower
Suite A7D
Los Angeles, CA 90033-1029
Phone
(323) 409-7556
NPI assigned
Apr 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1200 N State Street Clinic Tower
Suite A7D
Los Angeles, CA 90033-1029

Mailing address

1200 N State Street Clinic Tower
Suite A7D
Los Angeles, CA 90033-1029

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
I20210702000947 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2062813611

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Virginia Commonwealth University, School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11160 Warner Ave
Suite 323
Fountain Valley, CA 92708-4055
Phone (714) 751-7002

12601 Garden Grove Blvd
Garden Grove, CA 92843-1908
Phone (714) 741-2772

17100 Euclid St
Fountain Valley, CA 92708-4004
Phone (714) 966-7200

17772 Beach Blvd
Huntington Beach, CA 92647-6819
Phone (714) 842-1473

9920 Talbert Ave
Fountain Valley, CA 92708-5153
Phone (714) 378-7000

Hospital & facility affiliations

  • Lac/Olive View-UCLA Medical Center Hospital, Sylmar, CA, CCN 050040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Hospital & facility affiliations 1

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": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1548840895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STATE STREET CLINIC TOWER",
            "address_2": "SUITE A7D",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE STREET CLINIC TOWER",
            "address_2": "SUITE A7D",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-409-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNG",
        "first_name": "LILIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-12",
        "last_updated": "2021-04-12",
        "certification_date": "2021-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.