Individual provider Active NPI

Grace Chung

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1386060234
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95000515 Issued in CA
Practice address
333 S Catalina St Apt 425
Los Angeles, CA 90020-2079
Phone
(310) 800-3852
NPI assigned
Mar 14, 2014
Last updated
Nov 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95000515 CA Primary

Addresses

Primary practice location

333 S Catalina St Apt 425
Los Angeles, CA 90020-2079

Mailing address

333 S Catalina St Apt 425
Los Angeles, CA 90020-2079

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170310000019 CA Practitioner - Nurse Practitioner 6800170903 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

11560 W Pico Blvd
Los Angeles, CA 90064-1520
Phone (310) 477-8285

13365 W Washington Blvd
Los Angeles, CA 90066-5134
Phone (310) 504-1825

2090 Westwood Blvd
Los Angeles, CA 90025-6329
Phone (213) 814-4070

2110 W Sunset Blvd
Suite M
Los Angeles, CA 90026-7318
Phone (833) 873-2852

242 S Robertson Blvd
Beverly Hills, CA 90211-2811
Phone (310) 652-2300

26777 Agoura Rd
Suite B4
Calabasas, CA 91302-2967
Phone (818) 880-2225

3032 Wilshire Blvd
Suite a
Santa Monica, CA 90403-2370
Phone (310) 971-9957

4550 Van Nuys Blvd
Suite A4
Sherman Oaks, CA 91403-2844
Phone (818) 514-3631

4700 W Pico Blvd
Suite G 5
Los Angeles, CA 90019-4267
Phone (323) 840-1343

4730 Lincoln Blvd
Marina del Rey, CA 90292-6902
Phone (424) 352-0371

600 E Colorado Blvd
Suite 120
Pasadena, CA 91101-6800
Phone (323) 301-7988

6160 Laurel Canyon Blvd
Suite 160
North Hollywood, CA 91606-3287
Phone (213) 267-6536

8900 Venice Blvd
Suite 109
Culver City, CA 90232-2361
Phone (424) 282-5696

8985 Venice Blvd
Suite a 3B
Los Angeles, CA 90034-3344
Phone (424) 502-1020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Oct 27, 2018 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 27, 2018 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

Interoperability endpoints

  • Direct secure messaging: gchung211374@direct.cshs.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1394755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1386060234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S CATALINA ST APT 425",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900202079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S CATALINA ST APT 425",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900202079",
            "telephone_number": "310-800-3852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-14",
        "last_updated": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000515",
            "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": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.