NPIMap

Organization Active NPI

C &K Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1922316645
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

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.
Title
President
Phone
(323) 757-1853

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A46356 CA Primary

Addresses

Primary practice location

12610 S Western Ave
Los Angeles, CA 90047-5252

Mailing address

12610 S Western Ave
Los Angeles, CA 90047-5252
Phone (323) 757-1853

National Provider Directory

National Provider Directory

Locations

12610 S Western Ave
Los Angeles, CA 90047
Phone (323) 757-1853

NPI Registry JSON

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": []
}

Other providers in Los Angeles, CA

Sources for this page

  • 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.