Active NPI
Kenneth Huynh
- Student in an Organized Health Care Education/Training Program
- Orange, CA
National Provider Identifier
1366065146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 333 City Blvd W Ste 1600
Orange, CA 92868-5903 - Phone
- (714) 509-2377
- NPI assigned
- May 27, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
333 City Blvd W Ste 1600
Orange, CA 92868-5903
Mailing address
333 City Blvd W Ste 1600
Orange, CA 92868-5903
Phone (714) 509-2377
Other practice location 1
19555 N 59th Ave
Glendale, AZ 85308-6813
Phone (408) 872-5343
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221103000850 | CA | Order and Referring Only - Interventional Radiology | 3476920422 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20261 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616371200000",
"number": "1366065146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 CITY BLVD W STE 1600",
"city": "ORANGE",
"state": "CA",
"postal_code": "928685903",
"telephone_number": "714-509-2377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 CITY BLVD W STE 1600",
"city": "ORANGE",
"state": "CA",
"postal_code": "928685903",
"telephone_number": "714-509-2377"
}
],
"practiceLocations": [
{
"address_1": "19555 N 59th Ave",
"address_purpose": "LOCATION",
"city": "Glendale",
"state": "AZ",
"postal_code": "853086813",
"country_code": "US",
"telephone_number": "408-872-5343",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUYNH",
"first_name": "KENNETH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-27",
"last_updated": "2021-03-22",
"certification_date": "2021-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.