C &K Medical Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A46356 Issued in CA

Legal business name

C &K MEDICAL GROUP

Practice address

12610 S Western Ave
Los Angeles, CA 90047-5252

Phone

(323) 757-1853

Fax

(323) 757-1281

NPI assigned

Sep 15, 2010

Last updated

Sep 15, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jae Sung Chu, M.D.NPI 1063400745

Title

President

Phone

(323) 757-1853

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jae S Chu, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1063400745
  Authorized official Same address or phone

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

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284508800000",
    "number": "1922316645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12610 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900475252",
            "telephone_number": "323-757-1853",
            "fax_number": "323-757-1281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12610 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900475252",
            "telephone_number": "323-757-1853",
            "fax_number": "323-757-1281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C &K MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-15",
        "last_updated": "2010-09-15",
        "status": "A",
        "authorized_official_last_name": "CHU",
        "authorized_official_first_name": "JAE",
        "authorized_official_middle_name": "SUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-757-1853",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A46356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; 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.