| Nanoom Medical Group | |
|
866 S. Westmoreland Avenue Suite 101 Los Angeles CA 90005 | |
| (800) 821-5675 | |
| (213) 289-1166 |
| Full Name | Nanoom Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 866 S. Westmoreland Avenue, Los Angeles, California |
| Authorized Official Name and Position | Edwin H Choi (OWNER/CEO) |
| Authorized Official Contact | 8008215675 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nanoom Medical Group 866 S. Westmoreland Avenue Suite 101 Los Angeles CA 90005 Ph: (800) 821-5675 | Nanoom Medical Group 866 S. Westmoreland Avenue Suite 101 Los Angeles CA 90005 Ph: (800) 821-5675 |
| NPI Number | 1942591847 |
|---|---|
| Provider Enumeration Date | 04/26/2011 |
| Last Update Date | 07/22/2022 |
| Medicare PECOS PAC ID | 5092992644 |
|---|---|
| Medicare Enrollment ID | O20110607000636 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942591847 | NPI | - | NPPES |
| A54943 | Other | CA | CALIFORNIA LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A54943 (California) | Primary |
| Provider Name | Edwin Hyun-kyu Choi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245273820 PECOS PAC ID: 3971595562 Enrollment ID: I20041116000378 |
| Provider Name | Eun Shin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073665436 PECOS PAC ID: 6709067697 Enrollment ID: I20110225000171 |
| Provider Name | Jun Chung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205190659 PECOS PAC ID: 1254613524 Enrollment ID: I20170120001853 |
| Provider Name | Daesoon Leem |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1902289226 PECOS PAC ID: 0749593697 Enrollment ID: I20200115000019 |
| Provider Name | In-hyang Choi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588142137 PECOS PAC ID: 2860894847 Enrollment ID: I20210713003762 |
| Provider Name | Jeehoon Jang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639691579 PECOS PAC ID: 1254712102 Enrollment ID: I20220722002721 |
| Provider Name | Hongwoo Song |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417454869 PECOS PAC ID: 3375870918 Enrollment ID: I20220808000927 |
| Provider Name | Pauline Sujin Sambeli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225629231 PECOS PAC ID: 8729442561 Enrollment ID: I20230913001529 |
| Provider Name | Eun Shin |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1073665436 PECOS PAC ID: 6709067697 Enrollment ID: I20240610003579 |
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