MEDICARE: KENNETH DANL JUNG M.D.

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	207P00000X	Emergency Medicine Physician	G84105	CA

General Provider Information

NPI Number	:	1093730426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH DANL JUNG M.D.

Provider Business Mailing Address
First Line	:	1216 S CITRUS AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-1602
Country	:	US
Telephone Number	:	323-610-9691
Fax Number	:	323-772-6725

Provider Business Practice Location Address
First Line	:	1216 S CITRUS AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-1602
Country	:	US
Telephone Number	:	323-610-9691
Fax Number	:	323-772-6725

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	08/05/2025

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