Individual provider Active NPI

Andy Sokehng Koeum, RN

  • Registered Nurse
  • Long Beach, CA
National Provider Identifier
1720998743
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95428660 Issued in CA
Practice address
2600 Redondo Ave FL 5
Long Beach, CA 90806-2325
Phone
(844) 562-1212
NPI assigned
Sep 10, 2026
Last updated
Sep 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95428660 CA Primary

Addresses

Primary practice location

2600 Redondo Ave FL 5
Long Beach, CA 90806-2325

Mailing address

14442 Harvest Ave
Norwalk, CA 90650-4709
Phone (562) 556-2824

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1788998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1720998743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14442 HARVEST AVE",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504709",
            "telephone_number": "562-556-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 REDONDO AVE FL 5",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062325",
            "telephone_number": "844-562-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEUM",
        "first_name": "ANDY",
        "middle_name": "SOKEHNG",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-10",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95428660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.