EVERGREEN MEDICAL GROUP NPI 1760665772

NPI Information

  • NPI: 1760665772
  • Provider Name: EVERGREEN MEDICAL GROUP
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Other Name: EVERGREEN PUENTE HILLS URGENT CARE
  • Address: 1850 S AZUSA AVE
    SUITE 60
    HACIENDA HEIGHTS, CA
    ZIP 91745
  • Phone: (626) 965-8202

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NPI Details

EVERGREEN MEDICAL GROUP is a primary care clinic center in Hacienda Heights, CA. EVERGREEN MEDICAL GROUP NPI is 1760665772. The provider is registered as an organization entity type.
The provider Other Name Is Evergreen Puente Hills Urgent Care.

The provider's business location address is:

1850 S AZUSA AVE
SUITE 60
HACIENDA HEIGHTS, CA
ZIP 91745-813
Phone: (626) 965-8202
Fax: (626) 964-9893

The provider's authorized official is Robert Fan Yang Tzeng .
The authorized official title is Owner and has the following contact phone number (626) 965-8202.

The enumeration date for this NPI number is 12/12/2007 and was last updated on 12/12/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterA39498CALIFORNIANo
2261QP2300XClinic/CenterPrimary CareA39498CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1W11936MEDICARE PINCALIFORNIA
2GR0054080MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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