Organization Active NPI

James M Jung

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1316139223
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
JAMES M JUNG
Practice address
3511 W Olympic Blvd
101
Los Angeles, CA 90019-3563
Phone
(323) 766-1057
Fax
(323) 766-8790
NPI assigned
Aug 14, 2007
Last updated
Feb 27, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Authorized official

Name
James M Jung, M.D.NPI 1912920919
Title
President
Phone
(323) 766-1057

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
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

3511 W Olympic Blvd
101
Los Angeles, CA 90019-3563

Mailing address

3511 W Olympic Blvd
101
Los Angeles, CA 90019-3563
Phone (323) 766-1057

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040602001182 CA Part B Supplier - Clinic/Group Practice 1355323502 Receives reassigned benefits from 3 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

3511 W Olympic Blvd
Ste 101
Los Angeles, CA 90019
Phone (323) 766-1057

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 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488153600000",
    "number": "1316139223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 W OLYMPIC BLVD",
            "address_2": "101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900193563",
            "telephone_number": "323-766-1057",
            "fax_number": "323-766-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 W OLYMPIC BLVD",
            "address_2": "101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900193563",
            "telephone_number": "323-766-1057",
            "fax_number": "323-766-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES M JUNG",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2017-02-27",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-766-1057",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "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 Feb 27, 2017; 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.