Jin Gyo Jung

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95029707 Issued in CA

Practice address

9840 Jersey Ave Unit 8
Santa Fe Springs, CA 90670-3176

Phone

(714) 913-3086

NPI assigned

Apr 16, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Harbor Community Clinic IncGroup PAC ID 8022166826, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Harbor Community Clinic Inc.

  • Federally Qualified Health Center (FQHC)
  • San Pedro, CA
  • NPI 1467490425
  Medicare reassignment Care Compare group NPD
• Harbor Community Clinic Inc

  • Pediatrics Physician
  • San Pedro, CA
  • NPI 1831739614
  NPD

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

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1669226478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9840 JERSEY AVE UNIT 8",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9840 JERSEY AVE UNIT 8",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703176",
            "telephone_number": "714-913-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "JIN GYO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95029707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asha T Jordan
• Alex Josten
• Josue Diaz
• Aaron Jacob Juarez
• Precious Juarez
• Ace Monzon Kamantigue, N.P.
• Anastacia Kayne, LMFT
• Jason Keaton
• Dan Reid Kerkhoff
• Kevin J. Pelton MD, Inc.

• Nurse Practitioner in Santa Fe Springs, CA
• Providers in Santa Fe Springs, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.