Individual provider Active NPI

Roy Chien-Chung Fu, M.D.

  • Internal Medicine Physician
  • Glendale, CA
National Provider Identifier
1972686632
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A88997 Issued in CA
Practice address
1420 S Central Ave
Glendale, CA 91204-2508
Phone
(818) 507-4617
Fax
(818) 409-7615
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A88997 CA Primary

Addresses

Primary practice location

1420 S Central Ave
Glendale, CA 91204-2508

Mailing address

210 California Ave
#9
Santa Monica, CA 90403-3609
Phone (323) 819-6615

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090721000655 CA Practitioner - HospitalistPractitioner - Internal Medicine 1658423751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Torrance Health Association IncGroup PAC ID 1355302134, 298 clinicians

Practice addresses (Care Compare)

514 N Prospect Ave
FL 4
Redondo Beach, CA 90277-3040
Phone (310) 750-3300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A88997CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Torrance Health Association Inc CurrentSince Apr 1, 2020 Accepting new patients
Astrana Care Hospitalists, a Medical Corporation PastSince Jan 19, 2020 Accepting new patients

Locations

514 N Prospect Ave
Fl 4
Redondo Beach, CA 90277
Phone (310) 750-3300

3330 Lomita Blvd
Torrance, CA 90505
Phone (310) 517-4675

23326 Hawthorne Blvd
Ste 200
Torrance, CA 90505
Phone (310) 257-7205

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972686632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 CALIFORNIA AVE",
            "address_2": "#9",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904033609",
            "telephone_number": "323-819-6615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 S CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042508",
            "telephone_number": "818-507-4617",
            "fax_number": "818-409-7615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FU",
        "first_name": "ROY",
        "middle_name": "CHIEN-CHUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A88997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.