| Changsoo Medical Group | |
|
5832 Beach Blvd Unit 214 Buena Park CA 90621-5501 | |
| (714) 523-7575 | |
| (714) 523-7585 |
| Full Name | Changsoo Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 5832 Beach Blvd Unit 214, Buena Park, California |
| Authorized Official Name and Position | Grace Yoon (OFFICE MANGER) |
| Authorized Official Contact | 5623350008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Changsoo Medical Group 5832 Beach Blvd Unit 214 Buena Park CA 90621-5501 Ph: (714) 523-7575 | Changsoo Medical Group 5832 Beach Blvd Unit 214 Buena Park CA 90621-5501 Ph: (714) 523-7575 |
| NPI Number | 1790496107 |
|---|---|
| Provider Enumeration Date | 12/06/2022 |
| Last Update Date | 05/05/2025 |
| Certification Date | 05/05/2025 |
| Medicare PECOS PAC ID | 7214432806 |
|---|---|
| Medicare Enrollment ID | O20250924004149 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790496107 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Paul S Chang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487627261 PECOS PAC ID: 6507839628 Enrollment ID: I20040817000874 |
| Provider Name | Daniel H Kwon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639736846 PECOS PAC ID: 9830573088 Enrollment ID: I20221104002221 |
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