K Phun Medical Clinic Inc

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

K PHUN MEDICAL CLINIC INC

Practice address

2418 San Gabriel Blvd
Rosemead, CA 91770-3674

Phone

(626) 288-7321

Fax

(626) 571-5275

NPI assigned

Mar 2, 2022

Organization subpart

No

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

Authorized official

Name

Kenneth Phun, MDNPI 1801837927

Title

President

Phone

(626) 288-7321

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth Phun, MD

  • Psychiatry Physician
  • Rosemead, CA
  • NPI 1801837927
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1558018200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 SAN GABRIEL BLVD",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917703674",
            "telephone_number": "626-288-7321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 SAN GABRIEL BLVD",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917703674",
            "telephone_number": "626-288-7321",
            "fax_number": "626-571-5275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K PHUN MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "PHUN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-288-7321",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa L. Jong, MSW
• Gloria Lupe Juarez, LVN
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• K N Pharmacy
• Sanjida Kabir
• Joan Elizabeth Kailany, WHNP
• Kalpesh Bhavsar MD Professional Corporation
• Kang Dental Corporation
• Chen-En Kang, D.C.

• Adult Mental Health Clinic/Center in Rosemead, CA
• Providers in Rosemead, CA by specialty
• Adult Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.