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NPI Code Detail

MEDICARE: BUMIN KONG

MEDICARE: BUMIN KONG
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
1207P00000XEmergency Medicine PhysicianA178290CA
22081P2900XPain Medicine (Physical Medicine & Rehabilitation) PhysicianA178290CA

General Provider Information

NPI Number : 1497382220
Entity Type Code : Individual
Provider Name (Legal Business Name) : BUMIN KONG
Provider Business Mailing Address
First Line : 11234 ANDERSON ST
Second Line :
City : LOMA LINDA
State : CA
Zip : 92354-2804
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 558 SAINT CHARLES DR STE 200
Second Line :
City : THOUSAND OAKS
State : CA
Zip : 91360-3968
Country : US
Telephone Number : 805-379-2322
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2020
Last Update Date : 09/26/2025

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Directions to “ BUMIN KONG ” 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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