Individual provider Active NPI

Thomas L. Kun, M.D.

  • Gastroenterology Physician
  • Los Angeles, CA
National Provider Identifier
1508841321
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A23046 Issued in CA
Practice address
10225 Club PL
Los Angeles, CA 90064-3420
Phone
(310) 738-1054
NPI assigned
Dec 14, 2005
Last updated
Aug 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A23046 CA Primary

Addresses

Primary practice location

10225 Club PL
Los Angeles, CA 90064-3420

Mailing address

1301 20TH St 376
Santa Monica, CA 90404-2087
Phone (310) 829-6789

Other identifiers 1

IdentifierTypeStateIssuer
00A234060MedicaidCA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101215000622 CA Practitioner - Gastroenterology 1850489766 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23406CAMDDentist
A23046CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation CurrentSince Sep 12, 2018 Accepting new patients
Providence Saint John's Health Center Past Accepting new patients
The Regents of the University of California Past Accepting new patients

Locations

1301 20th St
Ste 280
Santa Monica, CA 90404
Phone (310) 829-6789

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

Organizations & group practices 4

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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1508841321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 20TH ST 376",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042087",
            "telephone_number": "310-829-6789",
            "fax_number": "310-935-3163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10225 CLUB PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900643420",
            "telephone_number": "310-738-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUN",
        "first_name": "THOMAS",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A23046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A234060",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.