Individual provider Active NPI

Ki Sung Che, M.D.

  • Internal Medicine Physician
  • Cerritos, CA
National Provider Identifier
1922139906
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A054222 Issued in CA
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

Updated by the provider on Aug 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
A054222CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jonah Medical Group, Inc. Internal Medicine PastSince Jul 1, 2011 Accepting new patients

Interoperability endpoints

  • FHIR API: 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.

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

Verify at the official NPI Registry.