Individual provider Active NPI

Angela Jinsook Oh, MD

  • Ophthalmology Physician
  • Fountain Valley, CA
National Provider Identifier
1881221968
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A190600 Issued in CA
Practice address
18111 Brookhurst St Ste 6400
Fountain Valley, CA 92708-6728
Phone
(714) 963-1444
Fax
(714) 963-1234
NPI assigned
Mar 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X A190600 CA
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X A190600 CA Primary

Addresses

Primary practice location

18111 Brookhurst St Ste 6400
Fountain Valley, CA 92708-6728

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240515000789 CA Practitioner - Ophthalmology 0143661603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of California, Geffen School of Medicine, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A190600CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jules Stein Eye Institute Medical Group CurrentSince Jul 1, 2024 Accepting new patients
Jules Stein Eye Institute Medical Group Single Specialty CurrentSince Jul 1, 2024 Accepting new patients
UCLA Medical Group Ophthalmology Past Accepting new patients

Locations

622 W Duarte Rd
Ste 101
Arcadia, CA 91007
Phone (310) 206-1166

18111 Brookhurst St
Ste 6400
Fountain Vly, CA 92708
Phone (714) 350-7258

100 Stein Plz
Fl 1
Los Angeles, CA 90095
Phone (310) 206-9566

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

150 N Orange Grove Blvd
#1400
Pasadena, CA 91103

625 S Fair Oaks Ave
Ste 280
Pasadena, CA 91105
Phone (626) 304-0070

1807 Wilshire Blvd
Ste 203
Santa Monica, CA 90403
Phone (310) 564-6507

Interoperability endpoints

  • Direct secure messaging: aoh503749@direct.cshs.org

Organizations & group practices 3

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 1

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1881221968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18111 BROOKHURST ST STE 6400",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086728",
            "telephone_number": "714-963-1444",
            "fax_number": "714-963-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OH",
        "first_name": "ANGELA",
        "middle_name": "JINSOOK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A190600",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A190600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.