Evergreen Medical Group

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A39498 Issued in CA

Legal business name

EVERGREEN MEDICAL GROUP

Practice address

1850 S Azusa Ave
Suite 60
Hacienda Heights, CA 91745-6813

Phone

(626) 965-8202

Fax

(626) 964-9893

NPI assigned

Dec 12, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert Fan Yang Tzeng, MDNPI 1578665014

Title

Owner

Phone

(626) 965-8202

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Evergreen Puente Hills Urgent Care Other name

Locations

Practitioners 1

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

• Robert Fan Yang Tzeng, MD

  • Internal Medicine Physician
  • Monterey Park, CA
  • NPI 1578665014
  NPD (past) Authorized official

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1760665772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 S AZUSA AVE",
            "address_2": "SUITE 60",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917456813",
            "telephone_number": "626-965-8202",
            "fax_number": "626-964-9893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 S AZUSA AVE",
            "address_2": "SUITE 60",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917456813",
            "telephone_number": "626-965-8202",
            "fax_number": "626-964-9893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-12",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "TZENG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "FAN YANG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-965-8202",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A39498",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A39498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0054080",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Puente Hills Urgent Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rocky Espinosa
• Fransheska Esquivel Garcia
• Madeline Estrada
• Maria Eusebi
• Evergreen Cerritos Medical Group, Inc.
• Falks Family Home
• Samantha Fernandez
• Kimberly Ferrand
• First Services Supplies Corp
• Sheree Fischer

• Primary Care Clinic/Center in Hacienda Heights, CA
• Providers in Hacienda Heights, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.