Individual provider Active NPI

Min Ae Chung, PA-C

  • Medical Physician Assistant
  • Anaheim, CA
National Provider Identifier
1801278908
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA52562 Issued in CA
Practice address
631 S Brookhurst St Ste 101
Anaheim, CA 92804-3563
Phone
(949) 297-3888
NPI assigned
Jun 24, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA52562 CA Primary

Addresses

Primary practice location

631 S Brookhurst St Ste 101
Anaheim, CA 92804-3563

Mailing address

631 S Brookhurst St Ste 101
Anaheim, CA 92804-3563
Phone (949) 297-3888

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
I20160805001575 CA Practitioner - Physician Assistant 1254634231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1010 W la Veta Ave
Suite 750
Orange, CA 92868-4312
Phone (714) 361-6600

Hospital & facility affiliations

  • Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52562CAMDMarriage & Family Therapist
PA52562CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Pulmonary and Primary Care of Orange County CurrentSince Dec 13, 2025 Accepting new patients
Jack Stewart MD Inc Past Accepting new patients

Locations

1010 W La Veta Ave
Ste 750
Orange, CA 92868
Phone (714) 361-6600

Interoperability endpoints

  • Direct secure messaging: mchung4109258@oc.providencedirect.org

Organizations & group practices 2

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": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1801278908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 S BROOKHURST ST STE 101",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043563",
            "telephone_number": "949-297-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 S BROOKHURST ST STE 101",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043563",
            "telephone_number": "949-297-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "MIN",
        "middle_name": "AE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA52562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.