NPIMap

Individual provider Active NPI

Dong W Mun, MD

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1053346940
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A66714 Issued in CA
Practice address
3511 W Olympic Blvd
Ste 101
Los Angeles, CA 90019-3563
Phone
(323) 766-1057
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A66714 CA Primary

Addresses

Primary practice location

3511 W Olympic Blvd
Ste 101
Los Angeles, CA 90019-3563

Mailing address

3511 W Olympic Blvd
#101
Los Angeles, CA 90019-3563
Phone (323) 766-1057

Other identifiers 1

IdentifierTypeStateIssuer
00A667140MedicaidCA

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
I20031215000992 CA Practitioner - Internal Medicine 8123925427 Reassigns benefits to 1 organization
Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10777 Westminster Ave
Los Angeles, CA 90034-5515
Phone (213) 446-7518

Hospital & facility affiliations

  • Cross Care, Inc Home health agency, Los Angeles, CA, CCN 059383
  • Maxlife Home Care Services, Inc Home health agency, Glendale, CA, CCN 059763
  • Unitedcare Hospice, Inc Hospice, Cerritos, CA, CCN A01645
  • Starline Hospice, Inc Hospice, Los Angeles, CA, CCN 751685
  • Hollywood Presbyterian Medical Center Hospital, Los Angeles, CA, CCN 050063
  • Pih Health Good Samaritan Hospital Hospital, Los Angeles, CA, CCN 050471
  • Hollywood Presbyterian Medical Center Inpatient rehabilitation facility, Los Angeles, CA, CCN 05T063
  • Grand Park Convalescent Hospital Nursing home, Los Angeles, CA, CCN 056244
  • Alcott Rehabilitation Hospital Nursing home, Los Angeles, CA, CCN 056293
  • Olympia Convalescent Hospital Nursing home, Los Angeles, CA, CCN 056321
  • Burlington Convalescent Hospital Nursing home, Los Angeles, CA, CCN 056326
  • Mid-Wilshire Health Care CNTR Nursing home, Los Angeles, CA, CCN 056174

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66714CAMDSocial Worker
A66714CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cha Hollywood Medical Center LP PastSince Apr 30, 2003 Accepting new patients
Ardent Healthcare, Inc. Past Accepting new patients

Organizations & group practices 3

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

Hospital & facility affiliations 12

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1053346940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 W OLYMPIC BLVD",
            "address_2": "#101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900193563",
            "telephone_number": "323-766-1057",
            "fax_number": "323-766-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 W OLYMPIC BLVD",
            "address_2": "STE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900193563",
            "telephone_number": "323-766-1057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUN",
        "first_name": "DONG",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A66714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A667140",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.