Bo Kong, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A103792 Issued in CA

Practice address

12675 La Mirada Blvd Ste 401
La Mirada, CA 90638-2236

Phone

(562) 789-5435

NPI assigned

Jul 28, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Bright Medical Associates, Inc.

  • Specialist
  • Whittier, CA
  • NPI 1578576880
  NPD (past)
• Children'S Hospital of Orange County

  • Children's Hospital
  • Orange, CA
  • NPI 1811080526
  NPD (past)

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1083879274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12675 LA MIRADA BLVD STE 401",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906382236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12675 LA MIRADA BLVD STE 401",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906382236",
            "telephone_number": "562-789-5435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 S Main St",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683835",
            "country_code": "US",
            "telephone_number": "714-997-3000 x1405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONG",
        "first_name": "BO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A103792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon J Kinard, MFT
• Kindred Hospital Soutbay
• KND Development 59 LLC
• Sung Woo Koh, MD
• Andrew Solanzo Kojo, PHARMD
• Divakar Krishnareddy, M.D
• Bon Seong Ku, L.AC
• Wayne Kuang, DO
• Konrad Kirk Kuenstler, PT
• Jana Kukla

• Pediatrics Physician in La Mirada, CA
• Providers in La Mirada, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.