Minchul Jung, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

35439 Issued in CA

Practice address

701 Howe Ave
C3
Sacramento, CA 95825-4670

Phone

(916) 972-1615

Fax

(916) 972-1615

NPI assigned

May 1, 2009

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Inglewood, CA
  • NPI 1821635079
  NPD
• RX-Fit Inc

  • Physical Therapist
  • Encino, CA
  • NPI 1619153269
  NPD (past)
• Sterling Provider Services Inc.

  • Physical Therapist
  • Simi Valley, CA
  • NPI 1134318975
  NPD (past)

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

{
    "created_epoch": "1241136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1346474574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 HOWE AVE",
            "address_2": "C3",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958254670",
            "telephone_number": "916-972-1615",
            "fax_number": "916-972-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 HOWE AVE",
            "address_2": "C3",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958254670",
            "telephone_number": "916-972-1615",
            "fax_number": "916-972-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "MINCHUL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-01",
        "last_updated": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "35439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Jung, MD
• Jooyeon Jung, MD
• Julianne Marie Jung, CCC-SLP
• Michael J Jung, M.D., M.B.A.
• Milli Amen Jung
• Peggy Diana Jung, NP
• Seung Ah Jung, DDS
• Seungjin Jung
• Hannah Jungkeit, CNC
• William Junglas, MD

• Physical Therapist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.