Carl Cheung Tung Kong, PHD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PHY30457 Issued in CA

Practice address

6122 Whittier Blvd
Los Angeles, CA 90022-4504

Phone

(323) 725-1250

Fax

(323) 726-9091

NPI assigned

Jan 6, 2006

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• 6122Pharmacy

  • Community/Retail Pharmacy
  • Los Angeles, CA
  • NPI 1124141270
  NPD
• Republic Medical Clinic PC

  • Nurse Practitioner
  • Los Angeles, CA
  • NPI 1861361537
  NPD (past)

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861470155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6122 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900224504",
            "telephone_number": "323-725-1250",
            "fax_number": "323-726-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6122 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900224504",
            "telephone_number": "323-725-1250",
            "fax_number": "323-726-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONG",
        "first_name": "CARL CHEUNG",
        "middle_name": "TUNG",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "PHY30457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA304570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roman Alekseyevich Kondratyuk, RN
• Lee Louis Konecke
• Gottfried E Konecny, MD
• Amy Sunim Kong, NP
• Byungsuk Alex Kong, L.AC.
• Christopher Yoon Kong, M.D.
• Eunice Kong, M.D.
• Grace E Kong, MD
• Heejun Kong
• Helen Kong

• Pharmacist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pharmacist 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.