Keith Kusunis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G59736 Issued in CA

Practice address

1770 N Orange Grove Ave Ste 101
Pomona, CA 91767-3027

Phone

(909) 469-9494

Fax

(909) 469-2120

NPI assigned

Aug 2, 2005

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1033110945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 N ORANGE GROVE AVE",
            "address_2": "SUTIE 101",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673027",
            "telephone_number": "909-469-9494",
            "fax_number": "909-620-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 N ORANGE GROVE AVE STE 101",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673027",
            "telephone_number": "909-469-9494",
            "fax_number": "909-469-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSUNIS",
        "first_name": "KEITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2023-03-07",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G59736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033110945",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Toshi Kuramatsu, LCSW
• Heather Miller Kurera, D.O.
• Abbey Rose Kurian
• Keith Kurose, MD
• Alka Kurup, RPH
• Drew Allen Kutcher
• Donald Kuy, PT, DPT
• Rachel Kwak
• Philip Kwok, O.D.
• Christine Kwon, MD

• Family Medicine Physician in Pomona, CA
• Providers in Pomona, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.