Peppertree Multispecialty Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G36420 Issued in CA

Legal business name

PEPPERTREE MULTISPECIALTY MEDICAL GROUP, INC.

Practice address

3220 S Brea Canyon Rd Ste H
Diamond Bar, CA 91765-3481

Phone

(909) 594-1848

Fax

(909) 594-7959

NPI assigned

Apr 10, 2007

Last updated

Jul 11, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Beau Michael Chung, DONPI 1841746799

Title

Medical Director

Phone

(949) 274-8807

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Beau Michael Chung, D.O.

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1841746799
  Medicare reassignment NPD Authorized official
• Lynn Akemi Uchizono, PA-C

  • Physician Assistant
  • Diamond Bar, CA
  • NPI 1245598259
  NPD (past)
• Rama S Venkat, M.D

  • Pediatrics Physician
  • Diamond Bar, CA
  • NPI 1740340041
  NPD (past)

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562803200000",
    "number": "1740303924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 BREA CANYON RD., STE H",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917653339",
            "telephone_number": "909-594-1848",
            "fax_number": "909-594-7959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 S BREA CANYON RD STE H",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917653481",
            "telephone_number": "909-594-1848",
            "fax_number": "909-594-7959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEPPERTREE MULTISPECIALTY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2019-07-11",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "BEAU",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "949-274-8807",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G36420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peace of Mind Home Healthcare,LLC
• Pediatrics Therapy Clinic an Occupational Therapy PC
• Peggy Chu Dental Corporation (Diamond Bar Smiles)
• Pei-CHI Wu DO a Professional Medical Corporation (DB Medical)
• Pelvic Power Women's Physical Therapy Inc.
• Oscar Perez, LCSW
• Nancy Minh Pham, PHARMD
• Warren Phan
• Rhea Philip
• Phillip Wunder DO Inc

• Family Medicine Physician in Diamond Bar, CA
• Providers in Diamond Bar, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.