Kevin C Jung, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

DC 25721 Issued in CA

Practice address

13762 Newport Ave Ste C
Tustin, CA 92780-4699

Phone

(714) 838-2225

NPI assigned

Aug 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Chong Kun Jung Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: kevin.jung.p1@direct.kcs.nextgenshare.com

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.

• KCS, Inc.

  dba KCS Health Center

  • Federally Qualified Health Center (FQHC)
  • Buena Park, CA
  • NPI 1861525602
  Medicare reassignment NPD
• KCS, Inc.

  dba KCS Health Center

  • Federally Qualified Health Center (FQHC)
  • Buena Park, CA
  • NPI 1831600634
  NPD

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629188438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13762 NEWPORT AVE STE C",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804699",
            "telephone_number": "714-838-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13762 NEWPORT AVE STE C",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804699",
            "telephone_number": "714-838-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "KEVIN",
        "middle_name": "C",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC 25721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHONG",
            "last_name": "JUNG",
            "middle_name": "KUN",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erika Juarez-Cruz
• Judy Benvenuto Marriage and Family Therapy Inc (The Well Therapy Group)
• Andrew Jun
• Ashley Jung, DPT
• Carol Jung, PA-C
• K Derifield LMFT Inc
• K Derifield LMFT Inc
• K&B Mag Corp. (Queens Home 3)
• Kabacare Tustin Ca PC
• Gena E Kadar, D.C.

• Sports Physician Chiropractor in Tustin, CA
• Providers in Tustin, CA by specialty
• Sports Physician Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.