Celleste Medical, Inc.

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

CELLESTE MEDICAL, INC.

Doing business as

Grace Medical Group

Practice address

7800 Commonwealth Ave Ste 101
Buena Park, CA 90621-2496

Phone

(714) 886-8321

NPI assigned

Jan 18, 2022

Organization subpart

No

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

Authorized official

Name

Nary Lee Cheng

Title

Chief Administrator

Phone

(213) 604-6879

Specialties & licenses 3

Addresses

Other names 1

• GRACE MEDICAL GROUP Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sung Hyun Kim, M.D

  • Internal Medicine Physician
  • Buena Park, CA
  • NPI 1447665369
  NPD (past)

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642464000000",
    "number": "1689325953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 COMMONWEALTH AVE STE 101",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906212496",
            "telephone_number": "714-886-8321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 COMMONWEALTH AVE STE 101",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906212496",
            "telephone_number": "714-886-8321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CELLESTE MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A",
        "authorized_official_last_name": "CHENG",
        "authorized_official_first_name": "NARY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATOR",
        "authorized_official_telephone_number": "213-604-6879"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRACE MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Guillian Elizabeth Cardenas
• Caremax RM Corporation (Caremax Pharmacy)
• Maria Guadalupe Carrillo, MSW
• Carter Medical Management, Inc (Prime Medical Resources)
• Christine B. Castro
• Center Ipa
• Centralia Elementary School District
• Centralia Elementary School District
• Martha Cerda, R.P.T., PA-C
• Juan Manuel Cervantes

• Multi-Specialty Clinic/Center in Buena Park, CA
• Providers in Buena Park, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.