Individual provider Active NPI

Misun Kang

  • Nurse Practitioner
  • Moorpark, CA
National Provider Identifier
1093397556
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95024003 Issued in CA
Practice address
252 Los Angeles Ave
Suite G
Moor Park, CA 93021
Phone
(805) 619-2966
NPI assigned
Apr 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95024003 CA Primary

Addresses

Primary practice location

252 Los Angeles Ave
Suite G
Moor Park, CA 93021

Mailing address

252 Los Angeles Ave
Suite G
Moor Park, CA 93021-4653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95024003CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1619222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1093397556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 LOS ANGELES AVE",
            "address_2": "SUITE G",
            "city": "MOOR PARK",
            "state": "CA",
            "postal_code": "930214653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 LOS ANGELES AVE",
            "address_2": "SUITE G",
            "city": "MOOR PARK",
            "state": "CA",
            "postal_code": "93021",
            "telephone_number": "805-619-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "MISUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-24",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95024003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorpark, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.