Individual provider Active NPI

Shirley Chung, M. D.

  • Family Medicine Physician
  • Placentia, CA
National Provider Identifier
1568682771
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A60060 Issued in CA
Practice address
1275 N Rose Dr Ste 130
Placentia, CA 92870-3919
Phone
(714) 990-1882
Fax
(714) 990-0826
NPI assigned
Apr 27, 2007
Last updated
Mar 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A60060 CA Primary

Addresses

Primary practice location

1275 N Rose Dr Ste 130
Placentia, CA 92870-3919

Mailing address

1275 N Rose Dr Ste 130
Placentia, CA 92870-3919
Phone (714) 990-1882

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
I20040807000191 CA Practitioner - Family Practice 9234101668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Irvine, California College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brea Family Care a Medical CorporationGroup PAC ID 5799757126, 2 clinicians

Practice addresses (Care Compare)

1275 N Rose Dr
Placentia, CA 92870-3919
Phone (714) 990-1882

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A60060CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brea Family Care a Medical Corporation CurrentSince Jun 21, 2004 Accepting new patients
Pih Health Whittier Hospital Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

Hospital & facility affiliations 4

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": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1568682771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 N ROSE DR STE 130",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928703919",
            "telephone_number": "714-990-1882",
            "fax_number": "714-990-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 N ROSE DR STE 130",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928703919",
            "telephone_number": "714-990-1882",
            "fax_number": "714-990-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "SHIRLEY",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-27",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A60060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placentia, CA

Sources for this page

Verify at the official NPI Registry.