NPIMap

Individual provider Active NPI

Philip W Chung, M.D.

  • Nephrology Physician
  • Torrance, CA
National Provider Identifier
1003881889
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A63887 Issued in CA
Practice address
2841 Lomita Blvd 215
Torrance, CA 90505-5111
Phone
(310) 379-2860
Fax
(310) 325-1144
NPI assigned
Feb 23, 2006
Last updated
Feb 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A63887 CA Primary

Addresses

Primary practice location

2841 Lomita Blvd 215
Torrance, CA 90505-5111

Mailing address

3291 Skypark Dr
Torrance, CA 90505-5004
Phone (310) 325-4517

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060112000737 CA Practitioner - NephrologyPractitioner - Internal Medicine 0446273726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
New York University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Internal Medicine and Nephrology Med. Group Inc.Group PAC ID 3173681400, 7 clinicians

Practice addresses (Care Compare)

3291 Skypark Dr
Torrance, CA 90505-5004
Phone (310) 325-4517

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A63887CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health System - Southern California Past Accepting new patients
Prime Healthcare Centinela, LLC Past Accepting new patients
Hilgards Dialysis, LLC PastSince Feb 2, 2017 Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Brotman Medical Center, Inc. Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients
Providence Health System Southern California Past Accepting new patients
Pacific Interventional Vascular Access Center Medical Corporation PastSince Sep 9, 2024 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: pwc109pcs@m566.primeclinicalsystems.direct-ci.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1003881889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3291 SKYPARK DR",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055004",
            "telephone_number": "310-325-4517",
            "fax_number": "310-325-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2841 LOMITA BLVD 215",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055111",
            "telephone_number": "310-379-2860",
            "fax_number": "310-325-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "PHILIP",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A63887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.