Individual provider Active NPI

Gloria Chen, PA-C

  • Physician Assistant
  • Glendora, CA
National Provider Identifier
1760704258
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA20534 Issued in CA
Practice address
130 W Route 66
Ste 208
Glendora, CA 91740-6249
Phone
(626) 335-4079
Fax
(626) 335-5507
NPI assigned
Feb 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA20534 CA Primary

Addresses

Primary practice location

130 W Route 66
Ste 208
Glendora, CA 91740-6249

Mailing address

130 W Route 66
Ste 208
Glendora, CA 91740-6249
Phone (626) 335-4079

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gchen1373004@oc.providencedirect.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170909000128 CA Practitioner - Physician Assistant 7810127446 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
20534CAMDMassage Therapist
PA20534CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Aug 1, 2017 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Aug 1, 2017 Accepting new patients
Amirpasha Ehsan MD, Inc Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

130 W Route 66
Ste 208
Glendora, CA 91740
Phone (626) 335-4079

Interoperability endpoints

  • Direct secure messaging: gchen1373004@oc.providencedirect.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1266969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1760704258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W ROUTE 66",
            "address_2": "STE 208",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917406249",
            "telephone_number": "626-335-4079",
            "fax_number": "626-335-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W ROUTE 66",
            "address_2": "STE 208",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917406249",
            "telephone_number": "626-335-4079",
            "fax_number": "626-335-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "GLORIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-24",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gchen1373004@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "100 E Valencia Mesa Dr Ste 111",
            "city": "Fullerton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928353816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.