| Buena Park Medical Group | |
|
6301 Beach Blvd Suite 101 Buena Park CA 90621-2840 | |
| (714) 994-5290 | |
| (714) 994-8090 |
| Full Name | Buena Park Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 6301 Beach Blvd, Buena Park, California |
| Authorized Official Name and Position | Martin Taehung Ahn (PRESIDENT) |
| Authorized Official Contact | 7149945290 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Buena Park Medical Group Po Box 277 Buena Park CA 90621-0277 Ph: (714) 994-5290 | Buena Park Medical Group 6301 Beach Blvd Suite 101 Buena Park CA 90621-2840 Ph: (714) 994-5290 |
| NPI Number | 1477625671 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9335191063 |
|---|---|
| Medicare Enrollment ID | O20050210000692 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477625671 | NPI | - | NPPES |
| 00A637280 | Medicaid | CA | |
| GR0099930 | Medicaid | CA | |
| 00A855760 | Medicaid | CA | |
| 00A615740 | Medicaid | CA | |
| 00G536930 | Medicaid | CA |
| Provider Name | Felicia K Tran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225100753 PECOS PAC ID: 6103880810 Enrollment ID: I20041112000731 |
| Provider Name | Edgardo M Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366514655 PECOS PAC ID: 3779535406 Enrollment ID: I20050211000126 |
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