Kyungsoo Korinn Go, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

8891 Central Ave
Montclair, CA 91763-1618

Phone

(909) 297-3361

NPI assigned

May 1, 2017

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Kyungsoo Lee Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Emergency Medicine Specialists of Orange County

  • Emergency Medicine Physician
  • Orange, CA
  • NPI 1740214733
  Medicare reassignment
• James E. Pierog, MD, Inc.

  dba Orange Health and Wellness

  • Urgent Care Clinic/Center
  • Orange, CA
  • NPI 1134432453
  NPD (past)

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1720514466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8891 CENTRAL AVE",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631618",
            "telephone_number": "909-297-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8891 CENTRAL AVE",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631618",
            "telephone_number": "909-297-3361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 W La Veta Ave Ste 755",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928684306",
            "country_code": "US",
            "telephone_number": "714-543-8911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GO",
        "first_name": "KYUNGSOO",
        "middle_name": "KORINN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYUNGSOO",
            "last_name": "LEE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kayla Monet Gilmer
• Marcos Andres Giraudo
• Unique Givens
• Glen Ridge Hospice, Inc.
• Glory Pharmacy Inc. (The Medicine Shoppe)
• Gobaud Orthopaedic Medical Clinic
• Daniel Sasan Gobaud, MD
• Andrea Patricia Godinez
• Susana Godinez
• Rebecca Godoy

• Physician Assistant in Montclair, CA
• Providers in Montclair, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.