1. Home
  2. Directory
  3. California
  4. Walnut
  5. Family Medicine
  6. NPI Profile

123 MEDICAL GROUP CORP.
NPI 1588029771
Family Medicine in Walnut, CA

Active since December 15, 2015CLIA 05D2112521 · Waiver
18800 AMAR RD STE C12, WALNUT, CA 91789(626) 788-9691(626) 608-0318 Get Directions Write a Review

NPPES record last updated: August 9, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 9, 2022, Dec 15, 2015 (2 updates tracked since 2015).

About 123 Medical Group Corp. NPPES

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

123 MEDICAL GROUP CORP. (NPI 1588029771) is a healthcare organization registered as a family medicine in Walnut, California and active in the NPI registry since December 2015. The organization holds a CLIA Waiver certificate valid through May 1, 2028 and lists Allan C Chang, President, as its authorized official.

NPPES Registry Identity

NPI1588029771
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business Name123 MEDICAL GROUP CORP.
Location Address18800 AMAR RD STE C12Walnut, CA 91789-4561
Mailing Address18800 Amar Rd Ste C12Walnut, CA 91789-4561 · (626) 788-9691 · Fax (626) 608-0318
Phone(626) 788-9691
Fax(626) 608-0318
Organization SubpartNo
Authorized OfficialAllan C ChangPresident · (626) 889-6917
Enumeration DateDecember 15, 2015
Last NPPES UpdateAugust 9, 20222 updates tracked since enumeration
NPPES CertifiedAugust 9, 2022
✔ NPI 1588029771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
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 ListedAcupuncturistTaxonomy 171100000X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
18800 AMAR RD STE C12, Walnut, CA 91789
Open in Google Maps ↗

Other Identifiers 1

Other1588029771Family Medicine

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 05D2112521

123 Medical Group Corp · Walnut, CA
Active · expires May 1, 2028
CLIA Number05D2112521
Laboratory TypeCommunity Clinic
Certificate Effective DateMay 2, 2026
Certificate Expiration DateMay 1, 2028
Laboratory DirectorRonita L. Anderson
Laboratory Phone(626) 788-9691
Laboratory Location123 Medical Group Corp18800 Amar Rd Ste C-12, Walnut, CA 91789
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

DR. ALLAN C CHANG LAC, DOM, DAOM
Acupuncturist
18800 AMAR RD STE C12
WALNUT, CA 91789
Los Angeles County (626) 788-9691

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 123 Medical Group Corp.'s NPI number?

The NPI number for 123 Medical Group Corp. is 1588029771. It was assigned to this organization in the NPPES registry on December 15, 2015.

Where is 123 Medical Group Corp. located?

123 Medical Group Corp. is located at 18800 Amar Rd Ste C12, Walnut, CA 91789. The listed phone number is (626) 788-9691.

What is 123 Medical Group Corp.'s specialty?

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

Does 123 Medical Group Corp. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2112521) is associated with this NPI, valid through May 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for 123 Medical Group Corp. was last updated on August 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.