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NPI Code Detail

MEDICARE: JOSHUA MANGUNSONG

MEDICARE: JOSHUA MANGUNSONG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1467392506
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA MANGUNSONG
Provider Business Mailing Address
First Line : 245 FOUNTAIN CT STE 215
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-2792
Country : US
Telephone Number : 859-323-6861
Fax Number : 859-323-1194
Provider Business Practice Location Address
First Line : 245 FOUNTAIN CT STE 215
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-2792
Country : US
Telephone Number : 859-323-6861
Fax Number : 859-323-1194
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2026
Last Update Date : 04/01/2026

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Directions to “ JOSHUA MANGUNSONG ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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