BUENA PARK MEDICAL GROUP
NPI 1477625671
Family Medicine in Buena Park, CA

Q: What is Buena Park Medical Group's NPI number?

The NPI number for Buena Park Medical Group is 1477625671. It was assigned to this organization in the NPPES registry on November 14, 2006.

Q: What is Buena Park Medical Group's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since November 14, 2006CLIA 05D0993856 · Waiver

6301 BEACH BLVD, SUITE 101, BUENA PARK, CA 90621(714) 994-5290(714) 994-8090 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

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About Buena Park Medical Group NPPES

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

BUENA PARK MEDICAL GROUP (NPI 1477625671) is a healthcare organization registered as a family medicine in Buena Park, California and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through November 26, 2027 and lists Martin Taehung Ahn, President, as its authorized official.

NPPES Registry Identity

NPI1477625671

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameBUENA PARK MEDICAL GROUP

Location Address6301 BEACH BLVD, SUITE 101Buena Park, CA 90621-2840

Mailing AddressPo Box 277Buena Park, CA 90621-0277 · (714) 994-5290 · Fax (714) 994-8090

Phone(714) 994-5290

Fax(714) 994-8090

Organization SubpartNo

Authorized OfficialMartin Taehung AhnPresident · (714) 994-5290

Enumeration DateNovember 14, 2006

Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration

✔ NPI 1477625671 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in CA · A061574✔ Licensed in CA · A85576

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedInternal MedicineTaxonomy 207R00000X · License G53693 (CA), A63728 (CA)

6301 BEACH BLVD, Buena Park, CA 90621

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Other Identifiers 5

Medicaid00A637280CA

MedicaidGR0099930CA

Medicaid00A855760CA

Medicaid00A615740CA

Medicaid00G536930CA

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 MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Buena Park Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Buena Park Medical Group, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Edgardo Gonzalez, M.D

Internal Medicine

NPI 1366514655

6301 BEACH BLVD SUITE 101
Buena Park, CA 90621

(714) 994-5290

✔ PECOS✔ Accepts MedicareSame address

Felicia Tran, MD

Internal Medicine

NPI 1225100753

6301 BEACH BLVD STE 101
Buena Park, CA 90621

(714) 994-5290

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 05D0993856

Buena Park Medical Group Inc · Buena Park, CA

Active · expires Nov 26, 2027

CLIA Number05D0993856

Laboratory TypePhysician Office

Certificate Effective DateNovember 27, 2025

Certificate Expiration DateNovember 26, 2027

Laboratory DirectorEdgardo M. Gonzales MD

Laboratory Phone(714) 994-5290

Laboratory LocationBuena Park Medical Group Inc6301 Beach Blvd, #101, Buena Park, CA 90621

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Buena Park Medical Group's NPI number?

The NPI number for Buena Park Medical Group is 1477625671. It was assigned to this organization in the NPPES registry on November 14, 2006.

Where is Buena Park Medical Group located?

Buena Park Medical Group is located at 6301 Beach Blvd Suite 101, Buena Park, CA 90621. The listed phone number is (714) 994-5290.

What is Buena Park Medical Group's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Buena Park Medical Group enrolled in Medicare?

Yes. Buena Park Medical Group is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Buena Park Medical Group?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to Buena Park Medical Group. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Buena Park Medical Group hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0993856) is associated with this NPI, valid through November 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Buena Park Medical Group was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.