Bounmany Kyle Keojampa, M.D.

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

134756 Issued in CA

Practice address

4640 Admiralty Way
Suite 718
Marina del Rey, CA 90292-6621

Phone

(310) 823-4444

Fax

(888) 857-4458

NPI assigned

Apr 23, 2008

Last updated

Jul 2, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: bkeojampa20075@direct.southcoast.org

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.

• Bounmany Kyle Keojampa, MD

  • Facial Plastic Surgery Physician
  • Cupertino, CA
  • NPI 1881953909
  NPD (past) Authorized official

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1972778843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 ADMIRALTY WAY",
            "address_2": "SUITE 718",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926621",
            "telephone_number": "310-823-4444",
            "fax_number": "888-857-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 ADMIRALTY WAY",
            "address_2": "SUITE 718",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926621",
            "telephone_number": "310-823-4444",
            "fax_number": "888-857-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOJAMPA",
        "first_name": "BOUNMANY",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "MA",
            "license": "242360",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "CA",
            "license": "134756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Katona, M.D.
• Yana Katzap-Nackman, BA, IBCLC, RLC
• Lisa Kellman, D.O.
• Anna Elizabeth Kendall, PSY.D.
• Kenneth Landis M D a Medical Corporation
• Kerri Keslow, M.D.
• Ketamine Uplift Inc.
• Haleh Keypour, LMFT
• Sanjay Kumar Khurana, M.D.
• Kianusch Kiai Inc

• Facial Plastic Surgery Physician in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Facial Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; 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.