MEDICARE: ROBERTA KUNG MD

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
1	207L00000X	Anesthesiology Physician	G74712	CA

General Provider Information

NPI Number	:	1033104203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERTA KUNG MD

Provider Business Mailing Address
First Line	:	9090 WILSHIRE BLVD
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-1848
Country	:	US
Telephone Number	:	800-394-4445
Fax Number	:

Provider Business Practice Location Address
First Line	:	1821 MARCHEETA PL
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90069-1116
Country	:	US
Telephone Number	:	800-394-4445
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	02/12/2026

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