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MIRAE MEDICAL CLINIC
NPI 1407267586
Internal Medicine in Los Angeles, CA

Active since May 12, 2014CLIA 05D2045637 · Waiver
2675 W OLYMPIC BLVD, SUITE 202, LOS ANGELES, CA 90006(213) 387-1541(866) 531-4907 Get Directions Write a Review

NPPES record last updated: May 12, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mirae Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIRAE MEDICAL CLINIC (NPI 1407267586) is a healthcare organization registered as an internal medicine in Los Angeles, California and active in the NPI registry since May 2014. The organization holds a CLIA Waiver certificate valid through August 16, 2026 and lists Hee Soo Jeong, President, as its authorized official.

NPPES Registry Identity

NPI1407267586
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameHEE SOO JEONG MD A PROFESSIONAL MEDICAL CORPORATION
Location Address2675 W OLYMPIC BLVD, SUITE 202Los Angeles, CA 90006-2880
Mailing Address2675 W Olympic Blvd, Suite 202Los Angeles, CA 90006-2880 · (213) 387-1541 · Fax (866) 531-4907
Phone(213) 387-1541
Fax(866) 531-4907
Organization SubpartNo
Authorized OfficialHee Soo JeongPresident · (213) 387-1541
Enumeration DateMay 12, 2014
✔ NPI 1407267586 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · A105825
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2675 W OLYMPIC BLVD, Los Angeles, CA 90006
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Other Names 1

Doing Business AsMirae Medical Clinic

Other Identifiers 1

OtherA105825CA · Professional License

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2045637

Mirae Medical Clinic · Los Angeles, CA
Active · expires Aug 16, 2026
CLIA Number05D2045637
Laboratory TypePhysician Office
Certificate Effective DateAugust 17, 2024
Certificate Expiration DateAugust 16, 2026
Laboratory DirectorHee Soo Jeong MD
Laboratory Phone(213) 387-1541
Laboratory LocationMirae Medical Clinic2675 W. Olympic Blvd., Ste. 202, Los Angeles, CA 90006
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEESOO JEONG M.D.
Internal Medicine
2675 W OLYMPIC BLVD, #202
LOS ANGELES, CA 90006
Los Angeles County (213) 387-1541
MR. HYUNG M SUNG DC
Chiropractor
2675 W OLYMPIC BLVD, 203
LOS ANGELES, CA 90006
Los Angeles County (213) 480-0778
YONG CHUN CHOE DDS INC
Dentist (General Practice)
2675 W OLYMPIC BLVD, 300
LOS ANGELES, CA 90006
Los Angeles County (213) 739-0150
DR. MI-JEONG LEE
Pediatrics
2675 W OLYMPIC BLVD, STE 103
LOS ANGELES, CA 90006
Los Angeles County (213) 252-0036
MIN S. PARK, M.D., INC.
Obstetrics & Gynecology
2675 W OLYMPIC BLVD, SUITE 100
LOS ANGELES, CA 90006
Los Angeles County (213) 382-0031
TERESA MEDICAL CENTER, INC.
Family Medicine
2675 W OLYMPIC BLVD
LOS ANGELES, CA 90006
Los Angeles County (213) 383-9955
JENNIFER MADRIGAL PA
Physician Assistant (Medical)
2675 W OLYMPIC BLVD
LOS ANGELES, CA 90006
Los Angeles County (213) 383-9955
SUNG SIM CHIROPRACTIC AND ACUPUNCTURE INC.
Chiropractor
2675 W OLYMPIC BLVD, 203
LOS ANGELES, CA 90006
Los Angeles County (213) 480-0778

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Hee Soo Jeong MD A Professional Medical Corporation's NPI number?

The NPI number for Hee Soo Jeong MD A Professional Medical Corporation is 1407267586. It was assigned to this organization in the NPPES registry on May 12, 2014. The provider is doing business as Mirae Medical Clinic.

Where is Hee Soo Jeong MD A Professional Medical Corporation located?

Hee Soo Jeong MD A Professional Medical Corporation is located at 2675 W Olympic Blvd Suite 202, Los Angeles, CA 90006. The listed phone number is (213) 387-1541.

What is Hee Soo Jeong MD A Professional Medical Corporation's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Hee Soo Jeong MD A Professional Medical Corporation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2045637) is associated with this NPI, valid through August 16, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Hee Soo Jeong MD A Professional Medical Corporation was last updated on May 12, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.