| Olive Tree Nursing Corporation | |
|
7227 Broadway Ste 405 Lemon Grove CA 91945-1505 | |
| (213) 663-8836 | |
| Not Available |
| Full Name | Olive Tree Nursing Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 7227 Broadway Ste 405, Lemon Grove, California |
| Authorized Official Name and Position | Yohan Han Hwang (CEO) |
| Authorized Official Contact | 2136638836 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Olive Tree Nursing Corporation 1208 Corte Mendi Chula Vista CA 91913-3547 Ph: (213) 663-8836 | Olive Tree Nursing Corporation 7227 Broadway Ste 405 Lemon Grove CA 91945-1505 Ph: (213) 663-8836 |
| NPI Number | 1194698043 |
|---|---|
| Provider Enumeration Date | 09/26/2025 |
| Last Update Date | 10/15/2025 |
| Certification Date | 10/15/2025 |
| Medicare PECOS PAC ID | 1759871874 |
|---|---|
| Medicare Enrollment ID | O20251106004801 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194698043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Andres Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548270200 PECOS PAC ID: 5294862371 Enrollment ID: I20100421000499 |
| Provider Name | Cristina Tobon-chung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053735019 PECOS PAC ID: 1951602549 Enrollment ID: I20151228000892 |
| Provider Name | John Danjuma Adeiza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174918585 PECOS PAC ID: 9234417890 Enrollment ID: I20161102000715 |
| Provider Name | Grace Danbi Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386112597 PECOS PAC ID: 8527305150 Enrollment ID: I20190121001016 |
| Provider Name | Yohan Han Hwang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609515642 PECOS PAC ID: 7012373244 Enrollment ID: I20230515000596 |
| Provider Name | Wilian Grijalva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831872357 PECOS PAC ID: 5092162842 Enrollment ID: I20231115003494 |
Cristina Tobon-chung Fnp a Professional Nursing Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7227 Broadway Ste 402, Lemon Grove, CA 91945 Phone: 619-410-9554 Fax: 619-567-3500 |
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