NPIMap

Individual provider Active NPI

Luon W Peng, DO

  • Nephrology Physician
  • Los Angeles, CA
National Provider Identifier
1407937105
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
20A8244 Issued in CA
Practice address
3731 E 3Rd St
Los Angeles, CA 90063-2401
Phone
(323) 222-4848
Fax
(323) 222-4800
NPI assigned
Oct 18, 2006
Last updated
Nov 2, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 20A8244 CA Primary

Addresses

Primary practice location

3731 E 3Rd St
Los Angeles, CA 90063-2401

Mailing address

3731 E 3Rd St
Los Angeles, CA 90063-2401
Phone (323) 222-4848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071211000764 CA Practitioner - NephrologyPractitioner - Internal Medicine 2860444122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Ohio University, College of Osteopathic Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3731 E 3Rd St
Los Angeles, CA 90063-2401
Phone (323) 222-4848

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A8244CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Healthcare Past Accepting new patients
Dignity Health Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Banner Pharmacy Services LLC Past Accepting new patients
White Memorial Medical Center Past Accepting new patients
Pasadena Hospital Association, LTD. Past Accepting new patients
Banner-University Medical Group Past Accepting new patients
Ahmc Monterey Park Hospital LP Past Accepting new patients
White Memorial Medical Group, Inc. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dr.luon.peng@drpengrenalcare.officeally.direct

Organizations & group practices 10

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1407937105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3731 E 3RD ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900632401",
            "telephone_number": "323-222-4848",
            "fax_number": "323-222-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3731 E 3RD ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900632401",
            "telephone_number": "323-222-4848",
            "fax_number": "323-222-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENG",
        "first_name": "LUON",
        "middle_name": "W",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "20A8244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.