| Prosper Oak Medical | |
|
1850 S Azusa Ave Ste 201 Hacienda Heights CA 91745-6854 | |
| (626) 913-2383 | |
| (626) 913-2013 |
| Full Name | Prosper Oak Medical |
|---|---|
| Speciality | Family Medicine |
| Location | 1850 S Azusa Ave Ste 201, Hacienda Heights, California |
| Authorized Official Name and Position | Edward T Lin (CEO) |
| Authorized Official Contact | 3104833887 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prosper Oak Medical 1850 S Azusa Ave Ste 201 Hacienda Heights CA 91745-6854 Ph: (626) 913-2383 | Prosper Oak Medical 1850 S Azusa Ave Ste 201 Hacienda Heights CA 91745-6854 Ph: (626) 913-2383 |
| NPI Number | 1649911371 |
|---|---|
| Provider Enumeration Date | 04/05/2022 |
| Last Update Date | 12/07/2023 |
| Certification Date | 12/07/2023 |
| Medicare PECOS PAC ID | 3375920549 |
|---|---|
| Medicare Enrollment ID | O20220510001912 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649911371 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Kuan Cheng Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235125790 PECOS PAC ID: 2163547308 Enrollment ID: I20100913000292 |
| Provider Name | Edward Tsung Lin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881122315 PECOS PAC ID: 1658608823 Enrollment ID: I20190809002395 |
| Provider Name | David Nguyen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669961801 PECOS PAC ID: 8426486077 Enrollment ID: I20200316000160 |
| Provider Name | Kuanchang Lu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972044295 PECOS PAC ID: 4587935416 Enrollment ID: I20210914003727 |
| Provider Name | Joshua Doangou Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235700469 PECOS PAC ID: 1557803590 Enrollment ID: I20240606000652 |
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