MRS. KYUNGSOO KORINN GO (NPI# 1720514466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720514466 |
| Entity Type | Individual |
| Full Name | MRS. KYUNGSOO KORINN GO |
| Other Name | MISS KYUNGSOO LEE |
| Credential | PA-C |
| Practice Address |
8891 Central Ave Montclair CA 91763-1618 |
| Practice Telephone | 9092973361 |
| Mailing Telephone | 9092973361 |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1010 W La Veta Ave Ste 755, Orange, CA 928684306 | 7145438911 |
| Street Address |
8891 CENTRAL AVE |
| City | MONTCLAIR |
| State | CA |
| Zip Code | 91763-1618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962428060 | Central Avenue Urgent Care Center | Clinic/Center | 8891 Central Ave, Montclair, CA 91763-1618 | 2006-07-14 |
| 1043775919 | Central Urgent Medical Care | Clinic/Center | 8891 Central Ave, Montclair, CA 91763-1618 | 2019-02-05 |
| 1336611813 | Beau Christian | Registered Nurse | 8891 Central Ave, Montclair, CA 91763-1618 | 2018-12-21 |
| 1992259071 | Daniel Mccullough | Physician Assistant | 8891 Central Ave, Suite A, Montclair, CA 91763-1618 | 2016-08-07 |
| 1265898126 | Noor Dakkak | Physician Assistant | 8891 Central Ave, Montclair, CA 91763-1618 | 2016-01-07 |
| 1467821363 | Danielle Barrett | Physician Assistant | 8891 Central Ave, Suite A, Montclair, CA 91763-1618 | 2015-09-21 |
| 1396137329 | Gale Estelle Laidlaw | Nurse Practitioner | 8891 Central Ave, Montclair, CA 91763-1618 | 2015-02-27 |
| 1093115941 | Michelle Anne Matyseck | Physician Assistant | 8891 Central Ave, Montclair, CA 91763-1618 | 2014-08-28 |
| 1992120042 | Joann Enderica | Physician Assistant | 8891 Central Ave, Suite A, Montclair, CA 91763-1618 | 2014-02-26 |
| 1083035984 | Dareen M Nassman | Physician Assistant | 8891 Central Ave, Suite A, Montclair, CA 91763-1618 | 2013-12-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194335760 | Cho Jeon Yun Dental Partnership | Dentist | 9655 Monte Vista Ave #406, Montclair, CA 91763 | 2020-08-07 |
| 1215498811 | Above Urgent Care Center | Emergency Medicine | 8891 N. Central Ave Ste A, Montclair, CA 91763 | 2019-03-27 |
| 1467936906 | Bronislava Kroulik | Behavior Technician | 4950 San Bernardino St Ste 101, Montclair, CA 91763 | 2018-09-20 |
| 1063936110 | Monique Karina Enriquez | Licensed Vocational Nurse | 5580 Moreno St #82, Montclair, CA 91763 | 2017-07-31 |
| 1972961159 | Lacy Pinsky | Specialist/Technologist | 5035 Flora St., Montclair, CA 91763 | 2016-02-03 |
| 1912333790 | Cinta Hospice Care Inc | Hospice Care, Community Based | 5050 Palo Verde Street, Suite 101, Montclair, CA 91763 | 2013-09-24 |
| 1720334626 | Priority One Hospice, Inc. | Hospice Care, Community Based | 4959 Palo Verde St Ste 107c, Montclair, CA 91763 | 2012-07-28 |
| 1689982498 | Paulina Trujillo Perez | Counselor | 9916 Central Ave., Montclair, CA 91763 | 2010-09-15 |
| 1982846499 | Esther Phillips Agepogu | Physician Assistant | 9301 Central Ave., Montclair, CA 91763 | 2009-03-30 |
| 1568633139 | Mahin Nosrati-jahromi | Dentist | 9509 Central Ave #d, Montclair, CA 91763 | 2008-03-21 |
| Find all providers in zip 91763 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629676358 | Sawyer Faith Eisaman | Physician Assistant | 4825 Cypress St Unit 217, Montclair, CA 91763-1451 | 2020-10-14 |
| 1841825585 | Bhumi Kaushik Patel | Physician Assistant | 5037 Saddleback St, Montclair, CA 91763-6539 | 2020-03-03 |
| 1831758598 | Samantha Rae Goman | Physician Assistant | 1 Bay Ave Ste 1, Montclair, NJ 07042-4837 | 2019-06-06 |
| 1881047892 | Sarah Kantelis | Physician Assistant | 9067 Sycamore Ave Unit 202, Montclair, CA 91763-1559 | 2016-07-14 |
| 1467892752 | Megan J Kera | Physician Assistant | 51 Park Street, Montclair, NJ 07042 | 2013-07-01 |
| 1063969467 | Barry Joseph Benzing | Physician Assistant | 1 Bay Ave, Montclair, NJ 07042-4837 | 2016-09-02 |
| 1588118921 | Sarah Tadros | Physician Assistant | 9301 Central Ave, Montclair, CA 91763-2445 | 2016-08-14 |
| 1992259071 | Daniel Mccullough | Physician Assistant | 8891 Central Ave, Suite A, Montclair, CA 91763-1618 | 2016-08-07 |
| 1356798490 | Nj Medical Practice PC | Physician Assistant | 1 Bay Ave, Montclair, NJ 07042-4837 | 2016-05-18 |
| 1659728921 | Citadel Emergency Physicians LLC | Physician Assistant | 1 Bay Ave, Montclair, NJ 07042-4837 | 2016-05-17 |
| Find all providers in MONTCLAIR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.