Individual provider Active NPI

Sokmom Lim Ung, FNP

  • Family Nurse Practitioner
  • Redondo Beach, CA
National Provider Identifier
1811530959
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95013119 Issued in CA
Practice address
1959 Kingsdale Ave
Redondo Beach, CA 90278-3417
Phone
(310) 210-1000
NPI assigned
Oct 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95013119 CA Primary

Addresses

Primary practice location

1959 Kingsdale Ave
Redondo Beach, CA 90278-3417

Mailing address

20208 Plaza de Madrid
Cerritos, CA 90703-7626
Phone (909) 900-7106

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220103000735 CA Practitioner - Nurse Practitioner 3375934219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alpha Hospitalist Group IncGroup PAC ID 7719266006, 14 clinicians

Practice addresses (Care Compare)

17100 Euclid St
Fountain Valley, CA 92708-4004
Phone (714) 966-7200

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Memorialcare Orange Coast Medical Center Hospital, Fountain Valley, CA, CCN 050678

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alpha Hospitalist Group Inc CurrentSince Dec 1, 2021 Accepting new patients

Locations

17150 Euclid St
Ste 200
Fountain Vly, CA 92708
Phone (714) 751-0995

17100 Euclid St
Fountain Vly, CA 92708
Phone (714) 966-7200

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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 3

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": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1811530959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20208 PLAZA DE MADRID",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907037626",
            "telephone_number": "909-900-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 KINGSDALE AVE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783417",
            "telephone_number": "310-210-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNG",
        "first_name": "SOKMOM",
        "middle_name": "LIM",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-22",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.