Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Madeline Hae Shin Lundgren, PA

Individual provider Physician Assistant · NPI 1265161699

Madeline Hae Shin Lundgren, PA is a Physician Assistant in Lodi, California. Qualified in 2022, 4 years ago. Practices with Clinic Services of California Medical Group Inc, a 66-clinician group and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2022
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

975 S Fairmont Ave
Lodi, CA 95240-5118
Phone: (209) 334-3411
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1265161699
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 9, 2022
Last updated in NPPESJune 20, 2022
Certification dateJune 20, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Clinic Services Of California Medical Group Inc — 66 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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