Active NPI
Charles Han Kyu Jun, DO
- Anesthesiology Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 20A20758
- Practice address
- 1500 San Pablo St FL 4
Los Angeles, CA 90033-5313 - Phone
- (323) 442-7400
- NPI assigned
- Jun 6, 2019
- Last updated
- Aug 17, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 125.074528 | IL | |
| Anesthesiology Physician | 207L00000X | 20A20758 | CA | Primary |
Addresses
Primary practice location
1500 San Pablo St FL 4
Los Angeles, CA 90033-5313
Mailing address
PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-7400
Other names 1
- Han Kyu Jun
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
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Arizona College of Osteopathic Medicine Mid Western University, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Phone (714) 871-3280
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A20758 | CA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Usc Care Medical Group, Inc | Current | Accepting new patients | |
| Allied Anesthesia Medical Group Inc | Anesthesiology | Current | Accepting new patients |
| Usc Care Medical Group, Inc | Anesthesiology | Current | Accepting new patients |
Locations
420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647
1124 S Main St
Ste 101
Corona, CA 92882
Phone (951) 737-6363
101 E Valencia Mesa Dr
Fullerton, CA 92835
Phone (714) 446-7505
1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849
1500 San Pablo St
Fl 4
Los Angeles, CA 90033
1421 Oakdale Rd
Modesto, CA 95355
Phone (209) 572-0151
455 S Main St
Orange, CA 92868
Phone (714) 289-4511
255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127
2900 Eureka Way
Redding, CA 96001
Phone (530) 225-8700
999 San Bernardino Rd
Upland, CA 91786
Phone (909) 920-4841
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Anesthesiology Physician
- Orange, CA
- NPI 1346267267
-
- General Practice Physician
- Los Angeles, CA
- NPI 1902846306
Anesthesiology
-
dba Fair Oaks Clinic
- Durable Medical Equipment & Medical Supplies
- Pasadena, CA
- NPI 1427937390
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Pomona, CA
- NPI 1407813660
-
- General Acute Care Hospital
- Upland, CA
- NPI 1780681189
-
dba Providence St. Mary Medical Center
- Advanced Practice Midwife
- Apple Valley, CA
- NPI 1043406440
Hospital
-
dba Providence St. Mary Medical Center
- General Acute Care Hospital
- Apple Valley, CA
- NPI 1669456299
-
dba Providence St. Mary Medical Center
- General Acute Care Hospital
- Apple Valley, CA
- NPI 1710109186
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692230400000",
"number": "1942869615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31309",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900310309",
"telephone_number": "323-442-7400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 SAN PABLO ST FL 4",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900335313",
"telephone_number": "323-442-7400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUN",
"first_name": "CHARLES",
"middle_name": "HAN KYU",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-06",
"last_updated": "2023-08-17",
"certification_date": "2023-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "125.074528",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "20A20758",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "HAN",
"last_name": "JUN",
"middle_name": "KYU",
"code": "1",
"type": "Former Name"
}
]
}
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 Aug 17, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.