Kenneth Phun, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A48951 Issued in CA

Practice address

2418 San Gabriel Blvd
Rosemead, CA 91770-3648

Phone

(626) 288-7321

Fax

(626) 571-5275

NPI assigned

Jun 9, 2006

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 identifiers 1

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

Specialty

Psychiatry

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• K Phun Medical Clinic Inc

  • Adult Mental Health Clinic/Center
  • Rosemead, CA
  • NPI 1558018200
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1801837927",
    "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": "917703648",
            "telephone_number": "626-288-7321",
            "fax_number": "626-571-5275"
        },
        {
            "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": "917703648",
            "telephone_number": "626-288-7321",
            "fax_number": "626-571-5275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHUN",
        "first_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A48951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A489510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Philip Chang, DDS, Inc.
• Phillip Z Kaw Dental Corporation
• Melinda Wood Phillips, M.D.
• Cynthia M. Philpot, MA
• Loan Phu, PHARMD
• Kevin Phun, PA-C
• Ruby Phun
• CHI Nam Phung
• Tai Thien Phung, PMHNP
• Pill Box Pharmacy, LLC

• Psychiatry Physician in Rosemead, CA
• Providers in Rosemead, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.