Individual provider Active NPI

Charles Poon, DO, MS

  • Emergency Medicine Physician
  • Glendale, CA
National Provider Identifier
1760001697
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A20304 Issued in CA
Practice address
1420 S Central Ave
Glendale, CA 91204-2508
Phone
(818) 502-1900
NPI assigned
Apr 10, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 20A20304 CA Primary

Addresses

Primary practice location

1420 S Central Ave
Glendale, CA 91204-2508

Mailing address

677 Church St NE
Marietta, GA 30060-1101

Other practice location 1

525 N Garfield Ave
Monterey Park, CA 91754-1205
Phone (626) 573-2222

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
I20230630001630 CA Practitioner - Emergency Medicine 9436572377 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gem Medical Group CorporationGroup PAC ID 3072984400, 54 clinicians

Practice addresses (Care Compare)

525 N Garfield Ave
Monterey Park, CA 91754-1202
Phone (626) 573-2222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Master of Science

State licenses

LicenseStateTypeSpecialty
20304CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jan 5, 2026 Accepting new patients
Victory Emergency Physicians Medical Group Inc Emergency Medicine CurrentSince May 16, 2025 Accepting new patients
Gem Medical Group Corporation Emergency Medicine CurrentSince Jun 1, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 5, 2026 Accepting new patients
Gem Medical Group Corporation Emergency Medicine CurrentSince Jun 1, 2023 Accepting new patients

Locations

1720 E Cesar E Chavez Ave
Los Angeles, CA 90033
Phone (323) 260-5781

900 S Atlantic Blvd
Monterey Park, CA 91754
Phone (626) 457-7450

525 N Garfield Ave
Monterey Park, CA 91754
Phone (626) 573-2222

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

1701 Santa Anita Ave
South El Monte, CA 91733
Phone (626) 350-7916

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1760001697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 CHURCH ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 S CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042508",
            "telephone_number": "818-502-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 N Garfield Ave",
            "address_purpose": "LOCATION",
            "city": "Monterey Park",
            "state": "CA",
            "postal_code": "917541205",
            "country_code": "US",
            "telephone_number": "626-573-2222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POON",
        "first_name": "CHARLES",
        "credential": "DO, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-10",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A20304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.