<unavail> in Fullerton, CA - Medicare Clinic/Center

is a medicare enrolled primary clinic (Clinic/center - Primary Care) in Fullerton, California. The current practice location for is 1817 W Orangethorpe Ave, Fullerton, California. For appointments, you can reach them via phone at (714) 449-0911. The mailing address for is 1817 W Orangethorpe Ave, Fullerton, California and phone number is (714) 449-0911.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1063040228. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (714) 449-0911.

Contact Information


	1817 W Orangethorpe Ave Fullerton CA 92833-4405
	(714) 449-0911
	Not Available

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Clinic/Center
Location	1817 W Orangethorpe Ave, Fullerton, California
Authorized Official Name and Position	Yong Soon Shin (NP)
Authorized Official Contact	7143497347
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
1817 W Orangethorpe Ave Fullerton CA 92833-4405 Ph: (714) 449-0911	1817 W Orangethorpe Ave Fullerton CA 92833-4405 Ph: (714) 449-0911

NPI Details:

NPI Number	1063040228
Provider Enumeration Date	03/31/2020
Last Update Date	11/11/2020

Medicare PECOS Information:

Medicare PECOS PAC ID	3476963877
Medicare Enrollment ID	O20201112002630

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063040228	NPI	-	NPPES
95005514	Medicaid	CA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261QP2300X	Clinic/center - Primary Care	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	Yong Soon Shin
Provider Type	Practitioner - Nurse Practitioner
Provider Identifiers	NPI Number: 1366985129 PECOS PAC ID: 7416231253 Enrollment ID: I20170223000663

Provider Name	Yujia Yang
Provider Type	Practitioner - Physical Therapist In Private Practice
Provider Identifiers	NPI Number: 1598412231 PECOS PAC ID: 7012302102 Enrollment ID: I20220329000505

Provider Name	Angela Kim
Provider Type	Practitioner - Occupational Therapist In Private Practice
Provider Identifiers	NPI Number: 1871066647 PECOS PAC ID: 6901284546 Enrollment ID: I20220609001918

Reviews and Comments

Clinic/Center in Fullerton, CA

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- Medicare Primary Care in Fullerton, CA