Nathan Sungmin Koh, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

17051 Sierra Lakes Pkwy Ste 102
Fontana, CA 92336-1274

Phone

(909) 428-1800

NPI assigned

Sep 24, 2025

Last updated

Feb 12, 2026By the provider in NPPES

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, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Emergency MedicineGroup PAC ID 8628128196, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern California Emergency Medicine

  • Urgent Care Clinic/Center
  • San Bernardino, CA
  • NPI 1639314255
  Medicare reassignment Care Compare group
• Dignity Health

  dba Mercy Medical Center Redding

  • General Acute Care Hospital
  • Redding, CA
  • NPI 1477671535
  NPD (past)

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

{
    "created_epoch": "1758672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1346113651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2964 QUAIL ST",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956165711",
            "telephone_number": "714-244-7906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17051 SIERRA LAKES PKWY STE 102",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361274",
            "telephone_number": "909-428-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOH",
        "first_name": "NATHAN",
        "middle_name": "SUNGMIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-24",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda C. Knudtson, MD
• Steven Young Ko, MD
• Constance R Koenig, CRNA
• Reshma Re Koenig
• Chang B. Koh, MD
• Kohan and Tsai Professional Dental Corporation of Fontana
• Neelu Kohli, M.D.
• Carlette Spengler Kolesnik, P.A.-C.
• Ravi Halappa Konchigeri, M.D.
• Lawrence B. Kong, MD

• Physician Assistant in Fontana, CA
• Providers in Fontana, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; 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.