Active NPI
Ktown Medical Group Inc
- Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
- Los Angeles, CA
National Provider Identifier
1104591999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
- 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
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kevin DO, MD
- Title
- Director
- Phone
- (818) 288-2757
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician | 2081N0008X | Primary |
Addresses
Primary practice location
3580 Wilshire Blvd Ste 115
Los Angeles, CA 90010-2502
Mailing address
3580 Wilshire Blvd Ste 115
Los Angeles, CA 90010-2502
Phone (818) 288-2757
National Provider Directory
National Provider DirectoryLocations
3580 Wilshire Blvd
Ste 115
Los Angeles, CA 90010
Phone (818) 288-2757
NPI Registry JSON
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": []
}
Other providers in Los Angeles, CA
Sources for this page
- 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.