| Orange County Joeun Medical Group Inc | |
|
9535 Garden Grove Blvd 104 Garden Grove CA 92844-1550 | |
| (714) 534-1112 | |
| (714) 534-1116 |
| Full Name | Orange County Joeun Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 9535 Garden Grove Blvd, Garden Grove, California |
| Authorized Official Name and Position | Edwin H Choi (DIRECTOR) |
| Authorized Official Contact | 7145341112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Orange County Joeun Medical Group Inc 9535 Garden Grove Blvd 104 Garden Grove CA 92844-1550 Ph: (714) 534-1112 | Orange County Joeun Medical Group Inc 9535 Garden Grove Blvd 104 Garden Grove CA 92844-1550 Ph: (714) 534-1112 |
| NPI Number | 1295965416 |
|---|---|
| Provider Enumeration Date | 07/22/2009 |
| Last Update Date | 01/02/2013 |
| Medicare PECOS PAC ID | 6709925266 |
|---|---|
| Medicare Enrollment ID | O20091123000704 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295965416 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jae Man M Park |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669628228 PECOS PAC ID: 6103967328 Enrollment ID: I20100111000482 |
| Provider Name | Eun Shin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073665436 PECOS PAC ID: 6709067697 Enrollment ID: I20110225000171 |
| Provider Name | Yong Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407007594 PECOS PAC ID: 3072778356 Enrollment ID: I20120712000273 |
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