Active NPI
Kingkan Rueanon
- Massage Therapist
- Los Angeles, CA
National Provider Identifier
1962359422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 4483
- Practice address
- 4524 Rosewood Ave
Los Angeles, CA 90004-3263 - Phone
- (562) 274-2019
- NPI assigned
- Mar 13, 2026
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 4483 | CA | Primary |
Addresses
Primary practice location
4524 Rosewood Ave
Los Angeles, CA 90004-3263
Mailing address
4524 Rosewood Ave
Los Angeles, CA 90004-3263
Phone (562) 274-2019
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4483 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773360000000",
"number": "1962359422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4524 ROSEWOOD AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900043263",
"telephone_number": "562-274-2019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4524 ROSEWOOD AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900043263",
"telephone_number": "562-274-2019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUEANON",
"first_name": "KINGKAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-03-13",
"last_updated": "2026-03-13",
"certification_date": "2026-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "CA",
"license": "4483",
"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 Mar 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.