Kevin Sam Vuong

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA58669 Issued in CA

Practice address

1127 Wilshire Blvd Ste 1618
Los Angeles, CA 90017-4007

Phone

(213) 977-1176

Fax

(213) 977-0668

NPI assigned

Oct 19, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Signature Medical Clinics IncGroup PAC ID 1759493216, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Signature Medical Clinics Inc

  • Urology Physician
  • Los Angeles, CA
  • NPI 1942436548
  Medicare reassignment Care Compare group
• Dignity Community Care

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1114081056
  NPD (past)

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1124627435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 WILSHIRE BLVD STE 1618",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174007",
            "telephone_number": "213-977-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 WILSHIRE BLVD STE 1618",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174007",
            "telephone_number": "213-977-1176",
            "fax_number": "213-977-0668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VUONG",
        "first_name": "KEVIN",
        "middle_name": "SAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-19",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA58669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Toan Vuong
• Connor Vuong
• Heu My Vuong, PHYSICIAN ASSISTANT
• Ivy Vuong, DDS
• Jenny Vuong, PHARM.D.
• Monique Vuong, RD
• Ngan Vuong, M.D.
• Phong Doxuan Vuong, M.D.
• Richard Quyen Vuong, DO
• Sherry Ngoc Vuong

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.