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

NPI Status: Active since May 12, 2014

Contact Information

2675 W OLYMPIC BLVD
SUITE 202
LOS ANGELES, CA
ZIP 90006
Phone: (213) 387-1541
Fax: (866) 531-4907

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  • Organization
  • Internal Medicine
  • CLIA Number: 05D2045637
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-16-2026

About MIRAE MEDICAL CLINIC

This page provides the complete NPI Profile along with additional information for Mirae Medical Clinic, an internist established in Los Angeles, California operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1407267586 assigned on May 2014. The practitioner's primary taxonomy code is 207R00000X with license number A105825 (CA). The provider is registered as an organization and their NPI record was last updated 12 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Mirae Medical Clinic. The authorized official of this NPI record is Hee Soo Jeong M.d. (President)

NPI
1407267586
Provider Legal Name
HEE SOO JEONG MD A PROFESSIONAL MEDICAL CORPORATION
Other Organization Name
MIRAE MEDICAL CLINIC
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
2675 W OLYMPIC BLVD SUITE 202 LOS ANGELES, CA 90006
Location Phone
(213) 387-1541
Location Fax
(866) 531-4907
Mailing Address
2675 W OLYMPIC BLVD SUITE 202 LOS ANGELES, CA 90006
Mailing Phone
(213) 387-1541
Mailing Fax
(866) 531-4907
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-12-2014
Last Update Date
05-12-2014
Code Navigator

An internist like Mirae Medical Clinic is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
A105825
License State
CA
Taxonomy Description
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.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

HEE SOO JEONG M.D.

Authorized Official Title
PRESIDENT
Authorized Official Phone
(213) 387-1541

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
A105825OTHER (01)CAPROFESSIONAL LICENSE

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D2045637
Facility Type
Physician Office
Certificate Effective Date
August 17, 2024
Certificate Expiration Date
August 16, 2026
Laboratory Director
HEE SOO JEONG MD
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Mirae Medical Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for MIRAE MEDICAL CLINIC

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1407267586, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
0
Doubled → 0
Pos 4
7
Unchanged
Pos 5
2
Doubled → 4
Pos 6
6
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
5
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 2 → 4 7 → 14 → 5 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 0 + 7 + 4 + 6 + 1 + 4 + 5 + 1 + 6 + 24 = 64

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 64 is 70. The difference is the calculated check digit.

70 - 64 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1407267586.

Other Providers at the Same Location


The following 10 providers are registered at the same or a nearby location.

Chiropractor
2675 W OLYMPIC BLVD, 203
LOS ANGELES, CA 90006
Dentist (General Practice)
2675 W OLYMPIC BLVD, 300
LOS ANGELES, CA 90006
Family Medicine
2675 W OLYMPIC BLVD
LOS ANGELES, CA 90006
Obstetrics & Gynecology
2675 W OLYMPIC BLVD, SUITE 100
LOS ANGELES, CA 90006
Chiropractor
2675 W OLYMPIC BLVD, 203
LOS ANGELES, CA 90006
Physician Assistant (Medical)
2675 W OLYMPIC BLVD
LOS ANGELES, CA 90006
Internal Medicine
2675 W OLYMPIC BLVD, #B-101
LOS ANGELES, CA 90006
Pediatrics
2675 W OLYMPIC BLVD, STE 103
LOS ANGELES, CA 90006
Dentist (General Practice)
2675 W OLYMPIC BLVD, 300
LOS ANGELES, CA 90006
Internal Medicine
2675 W OLYMPIC BLVD, #202
LOS ANGELES, CA 90006

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1407267586, enumerated as an "organization" on May 12, 2014.

The provider is located at 2675 W OLYMPIC BLVD SUITE 202 LOS ANGELES, CA 90006 and the phone number is (213) 387-1541.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.