Individual provider Active NPI

Yin Phung

  • Medical Physician Assistant
  • Paramount, CA
National Provider Identifier
1629499934
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
51266 Issued in CA
Practice address
16660 Paramount Blvd Ste 110
Paramount, CA 90723
Phone
(562) 633-2021
NPI assigned
Jan 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 51266 CA Primary

Addresses

Primary practice location

16660 Paramount Blvd Ste 110
Paramount, CA 90723

Mailing address

16660 Paramount Blvd Ste 110
Paramount, CA 90723-5457

Other practice location 1

16660 Paramount Blvd Ste 110
Paramount, CA 90723
Phone (562) 633-2021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Marcelo-Mangune Medical Corporation PastSince Oct 6, 2019 Accepting new patients

Organizations & group practices 1

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": "1388793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1629499934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16660 PARAMOUNT BLVD STE 110",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907235457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16660 PARAMOUNT BLVD STE 110",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "90723",
            "telephone_number": "562-633-2021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16660 Paramount Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Paramount",
            "state": "CA",
            "postal_code": "90723",
            "country_code": "US",
            "telephone_number": "562-633-2021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHUNG",
        "first_name": "YIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-04",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "51266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramount, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.