NPIMap

Organization Active NPI

Joseph K Ku MD, a Professional Corporation

  • Plastic and Reconstructive Surgery Physician
  • Riverside, CA
National Provider Identifier
1265610737
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
A77679 Issued in CA
Legal business name
JOSEPH K KU MD, A PROFESSIONAL CORPORATION
Practice address
3975 Jackson St
Suite 205
Riverside, CA 92503-3901
Phone
(951) 687-1162
Fax
(951) 687-1144
NPI assigned
Feb 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Authorized official

Name
Dr. Joseph K Ku, M.D.NPI 1649393760
Title
Owner
Phone
(619) 384-3329

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X A77679 CA Primary

Addresses

Primary practice location

3975 Jackson St
Suite 205
Riverside, CA 92503-3901

Mailing address

3975 Jackson St
Suite 205
Riverside, CA 92503-3901
Phone (951) 687-1162

Other names 1

  • Precision Plastic Surgery Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080421000489 CA Part B Supplier - Clinic/Group Practice 4385722065 Receives reassigned benefits from 10 practitioners
Practice locations: Riverside, CA

National Provider Directory

National Provider Directory

Locations

10888 Foothill Blvd
Rancho Cucamonga, CA 91730
Phone (909) 463-0715

3975 Jackson St
Ste 205
Riverside, CA 92503
Phone (909) 688-3849

6848 Magnolia Ave
Ste 220
Riverside, CA 92506
Phone (951) 683-1166

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1265610737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 JACKSON ST",
            "address_2": "SUITE 205",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033901",
            "telephone_number": "951-687-1162",
            "fax_number": "951-687-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 JACKSON ST",
            "address_2": "SUITE 205",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033901",
            "telephone_number": "951-687-1162",
            "fax_number": "951-687-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH K KU MD, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "KU",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-384-3329",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A77679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Precision Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.