Ktown Medical Group Inc

Primary specialty

Neuromuscular Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081N0008X

Legal business name

KTOWN MEDICAL GROUP INC

Practice address

3580 Wilshire Blvd Ste 115
Los Angeles, CA 90010-2502

Phone

(818) 288-2757

NPI assigned

Aug 12, 2021

Last updated

Aug 12, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kevin DO, MDNPI 1104078880

Title

Director

Phone

(818) 288-2757

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin T. DO, M.D.

  • Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
  • Tustin, CA
  • NPI 1104078880
  Authorized official Same address or phone

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1104591999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3580 WILSHIRE BLVD STE 115",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102502",
            "telephone_number": "818-288-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 WILSHIRE BLVD STE 115",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102502",
            "telephone_number": "818-288-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KTOWN MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "DO",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "818-288-2757",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081N0008X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Neuromuscular Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.