Princeton Physicians Associates Inc.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A42588 Issued in CA

Legal business name

PRINCETON PHYSICIANS ASSOCIATES INC.

Practice address

227 W Valley Blvd Ste 298B
San Gabriel, CA 91776-3782

Phone

(626) 288-8292

Fax

(626) 288-8789

NPI assigned

Jul 16, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Suisun Simon Chan, M.D.NPI 1801815527

Title

Owner

Phone

(626) 288-8292

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Suisun Simon Chan, M.D.

  • Gastroenterology Physician
  • Monterey Park, CA
  • NPI 1801815527
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563926400000",
    "number": "1841217726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 W VALLEY BLVD STE 298B",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763782",
            "telephone_number": "626-288-8292",
            "fax_number": "626-288-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 W VALLEY BLVD STE 298B",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763782",
            "telephone_number": "626-288-8292",
            "fax_number": "626-288-8789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON PHYSICIANS ASSOCIATES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2019-07-24",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "SUISUN",
        "authorized_official_middle_name": "SIMON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-288-8292",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A42588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0071580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in San Gabriel, CA
• Providers in San Gabriel, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.