Individual provider Active NPI

Kenneth Leung

  • Student in an Organized Health Care Education/Training Program
  • Los Angeles, CA
National Provider Identifier
1609239227
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1200 N State St
Los Angeles, CA 90089-1001
Phone
(323) 226-7556
NPI assigned
Mar 31, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1200 N State St
Los Angeles, CA 90089-1001

Mailing address

1200 N State St
Los Angeles, CA 90089-1001

Other identifiers 1

IdentifierTypeStateIssuer
KL3232267556MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190128003026 CA Practitioner - Internal Medicine 8426311184 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Southern California Keck School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, shared by 4 NPIs, 11,250 clinicians

Practice addresses (Care Compare)

1011 Balwin Park Blvd
Baldwin Park, CA 91706-5806
Phone (626) 851-1011

Hospital & facility affiliations

  • Kaiser Foundation Hospital - Baldwin Park Hospital, Baldwin Park, CA, CCN 050723

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Sep 12, 2022 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Sep 4, 2018 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Sep 4, 2018 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 12, 2022 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Healthcare Partners Affiliates Medical Group Current Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 10, 2025 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

1011 Baldwin Park Blvd
Baldwin Park, CA 91706
Phone (626) 851-1011

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

797 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 535-2434

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

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1609239227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900891001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900891001",
            "telephone_number": "323-226-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUNG",
        "first_name": "KENNETH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-31",
        "last_updated": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "KL3232267556",
            "state": "CA"
        }
    ],
    "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": "1011 Baldwin Park Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917065806",
            "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.