Individual provider Active NPI

Kenny Ekachai Vongbunyong

  • Hospitalist Physician
  • Orange, CA
National Provider Identifier
1871179655
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A181958 Issued in CA
Practice address
101 The City Dr S Ste 40
Orange, CA 92868-3201
Phone
(714) 456-5691
NPI assigned
Mar 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X A181958 CA Primary

Addresses

Primary practice location

101 The City Dr S Ste 40
Orange, CA 92868-3201

Mailing address

6138 Whitewood Ave
Lakewood, CA 90712-1243

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240610003706 CA Practitioner - Internal Medicine 0749678464 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A181958CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California-Irvine Hospitalist CurrentSince Apr 2, 2024 Accepting new patients

Locations

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

101 The City Dr S
Ste 40
Orange, CA 92868
Phone (714) 456-5691

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.

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1871179655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6138 WHITEWOOD AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S STE 40",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-5691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONGBUNYONG",
        "first_name": "KENNY",
        "middle_name": "EKACHAI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A181958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.