NPIMap

Individual provider Active NPI

Kenneth S. Jung II, M.D.

  • Orthopaedic Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1417925462
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A90948 Issued in CA
Practice address
6801 Park Ter
Los Angeles, CA 90045-1543
Phone
(310) 665-7200
Fax
(888) 972-8151
NPI assigned
Mar 8, 2006
Last updated
Aug 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A90948 CA Primary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X A90948 CA
Foot & Ankle Surgery Podiatrist 213ES0103X A90948 CA

Addresses

Primary practice location

6801 Park Ter
Los Angeles, CA 90045-1543

Mailing address

6801 Park Terrace Drive
Los Angeles, CA 90045
Phone (310) 665-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.
Opted out of Medicare
Previously, effective Sep 1, 2012 through Sep 1, 2026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
90948CAMDMarriage & Family Therapist
A90948CAMDOrthopaedic Foot and Ankle Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chapman Medical Center Inc Past Accepting new patients
Ronald S Kvitne MD Inc Orthopaedic Surgery Past Accepting new patients
White Memorial Medical Center Past Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
Cedars-Sinai Medical Care Foundation Past Accepting new patients
Prime Healthcare Centinela, LLC Past Accepting new patients
Pasadena Hospital Association, LTD. Past Accepting new patients
Kerlan-Jobe Orthopaedic Clinic Orthopaedic Surgery PastSince Jul 23, 2014 Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
Cedars-Sinai Marina Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kjung212128@direct.cshs.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1417925462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 PARK TERRACE DRIVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90045",
            "telephone_number": "310-665-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 PARK TER",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900451543",
            "telephone_number": "310-665-7200",
            "fax_number": "888-972-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "KENNETH",
        "middle_name": "S.",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A90948",
            "primary": true
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "CA",
            "license": "A90948",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "A90948",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.