Organization Active NPI

Ktown Medical Group Inc

  • Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
  • Los Angeles, CA
National Provider Identifier
1104591999
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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)CodeLicenseStatePrimary
Neuromuscular Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

Locations

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.

Verify at the official NPI Registry.