Individual provider Active NPI

Sungjin Kuon, D.O

  • Family Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1124555842
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A18221 Issued in CA
Practice address
2336 Santa Monica Blvd Ste 301
Santa Monica, CA 90404-2067
Phone
(310) 998-9118
Fax
(310) 829-9318
NPI assigned
May 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A18221 CA Primary

Addresses

Primary practice location

2336 Santa Monica Blvd Ste 301
Santa Monica, CA 90404-2067

Mailing address

5767 W Century Blvd Suite 400
Los Angeles, CA 90095-5631
Phone (310) 301-8707

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
I20200728000208 CA Practitioner - Family Practice 1557785268 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Regents of the University of CaliforniaGroup PAC ID 1355248584, 1,426 clinicians

Practice addresses (Care Compare)

100 Medical Plaza
Los Angeles, CA 90095-0001

100 Medical PLZ
Suite 310
Los Angeles, CA 90095-0001
Phone (310) 825-7922

200 Medical Plaza
Los Angeles, CA 90095-0001

200 Medical PLZ
Los Angeles, CA 90095-0001

200 UCLA Medical PLZ
Suite 165 34
Los Angeles, CA 90095-0001
Phone (310) 824-8403

2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381

2428 Santa Monica Blvd
Santa Monica, CA 90404-2046

3500 Lomita Blvd
Suite 300
Torrance, CA 90505-5038
Phone (310) 257-0028

514 N Prospect Ave
Redondo Beach, CA 90277-3036
Phone (310) 937-8555

900 Weyburn Place
Suite 14 171
Los Angeles, CA 90095-0001
Phone (310) 825-8173

Hospital & facility affiliations

  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112
  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A18221CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
The Regents of the University of California CurrentSince Aug 1, 2022 Accepting new patients
Memorialcare Medical Foundation Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
UCLA Medical Group Family Medicine Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

24302 Paseo de Valencia
Ste 200
Laguna Hills, CA 92653
Phone (949) 458-8252

2110 N Bellflower Blvd
Long Beach, CA 90815
Phone (562) 346-2222

450 E Spring St
Ste 1
Long Beach, CA 90806
Phone (562) 933-0050

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

File 55737
Los Angeles, CA 90074

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

2336 Santa Monica Blvd
Ste 301
Santa Monica, CA 90404
Phone (310) 998-9118

100 Moody Ct
Ste 200
Thousand Oaks, CA 91360
Phone (805) 418-3500

3500 Lomita Blvd
Ste 302
Torrance, CA 90505
Phone (310) 257-0028

Interoperability endpoints

  • Direct secure messaging: skuon1014839@direct.uclahealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1124555842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD SUITE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900955631",
            "telephone_number": "310-301-8707",
            "fax_number": "310-301-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2336 SANTA MONICA BLVD STE 301",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042067",
            "telephone_number": "310-998-9118",
            "fax_number": "310-829-9318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUON",
        "first_name": "SUNGJIN",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-12",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A18221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.