Dongwhan Dustin Im, PHYSICIAN ASSISTANT
NPI 1174257414ActiveIndividual· Physician Assistant· Fullerton, CA
Physician Assistant (PHYSICIAN ASSISTANT) with Providence Medical Foundation, practicing in Fullerton, California. Part D covered 676 prescriptions written in 2024, 97% of them generic. Boston Scientific Corporation was the largest of 5 companies reporting payments in 2024, $829.46 in all, mostly food and beverage. Lists Providence St. Joseph Hospital as a hospital affiliation.
Overview
| NPI | 1174257414 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHYSICIAN ASSISTANT |
| Sole proprietor | Yes |
| NPI issued | Jul 12, 2022 |
| Last updated in NPPES | Jun 18, 2026 |
| Certified by provider | Jun 18, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | — | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (CA) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 676 · 704 30-day fills |
|---|---|
| Patients | 170 |
| Total drug cost | $13,282 |
| Generic share | 97% of claims |
Education and affiliations
| Graduation year | 2022 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Providence Medical FoundationVictorville, CA · 1,466 clinicians
Hospital affiliation
- Providence St. Joseph HospitalOrange, CA
Industry payments (Open Payments)
- 2024$829.46 · 13 payments from 5 companies
Top paying companies in 2024
| Company | Amount | Payments |
|---|---|---|
| Boston Scientific Corporation | $608.88 | 7 |
| Medtronic, Inc. | $120.97 | 1 |
| Ibsa Pharma Inc. | $57.33 | 3 |
| Novo Nordisk Inc | $23.37 | 1 |
| Pfizer Inc. | $18.91 | 1 |
What the 2024 payments were for
- Food and Beverage$590.63 · 12 payments
- Travel and Lodging$238.83 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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