Active NPI
Ki Sung Che, M.D.
- Internal Medicine Physician
- Cerritos, CA
National Provider Identifier
1922139906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A054222
- Practice address
- 12506 South St
Cerritos, CA 90703-7134 - Phone
- (562) 809-0142
- NPI assigned
- Mar 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A054222 | CA | Primary |
Addresses
Primary practice location
12506 South St
Cerritos, CA 90703-7134
Mailing address
12506 South St
Cerritos, CA 90703-7134
Phone (562) 809-0142
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100211000355 | CA | Practitioner - Internal Medicine | 4688717721 | Practice locations: Cerritos, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A054222 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jonah Medical Group, Inc. | Internal Medicine | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IBFCCD
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.
-
- Family Medicine Physician
- Los Angeles, CA
- NPI 1942591847
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314230400000",
"number": "1922139906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12506 SOUTH ST",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907037134",
"telephone_number": "562-809-0142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12506 SOUTH ST",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907037134",
"telephone_number": "562-809-0142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHE",
"first_name": "KI",
"middle_name": "SUNG",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-08",
"last_updated": "2011-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A054222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cerritos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.