Individual provider Active NPI

Kenny Hung Vo I

  • Pediatrics Physician
  • Santa Monica, CA
National Provider Identifier
1104313501
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A163668 Issued in CA
Practice address
1260 15TH St Ste 1002
Santa Monica, CA 90404-1145
Phone
(424) 259-8570
NPI assigned
Apr 20, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A163668 CA Primary
Pediatric Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0207X A163668 CA

Addresses

Primary practice location

1260 15TH St Ste 1002
Santa Monica, CA 90404-1145

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

200 Ucla Medical Plz Ste 265
Los Angeles, CA 90095-8344
Phone (310) 825-0867

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250923004462 CA Practitioner - Pediatric Medicine 4789058736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Eastern Virginia Medical School, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A163668CAMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Multi-Specialty CurrentSince Sep 1, 2025 Accepting new patients
UCLA Medical Group Multi-Specialty Past Accepting new patients

Locations

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

10833 Le Conte Ave
#12311
Los Angeles, CA 90095
Phone (310) 825-9124

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

10833 Le Conte Ave
#951752
Los Angeles, CA 90095

200 UCLA Medical Plz
Ste 265
Los Angeles, CA 90095
Phone (310) 206-2429

892 Aerovista Pl
Ste 210
San Luis Obispo, CA 93401
Phone (805) 549-8023

1260 15th St
Ste 1002
Santa Monica, CA 90404
Phone (424) 259-8570

215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435

Interoperability endpoints

  • Direct secure messaging: kvo1005399@direct.uclahealth.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1104313501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 15TH ST STE 1002",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041145",
            "telephone_number": "424-259-8570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Ucla Medical Plz Ste 265",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900958344",
            "country_code": "US",
            "telephone_number": "310-825-0867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VO",
        "first_name": "KENNY",
        "middle_name": "HUNG",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-20",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A163668",
            "primary": true
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "CA",
            "license": "A163668",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.