Kenneth Phong, NP is a medicare enrolled "Nurse Practitioner - Family" physician in Los Angeles, California. His current practice location is
757 Westwood Plz, Los Angeles, California. You can reach out to his office (for appointments etc.) via phone at
(310) 825-6301.
Kenneth Phong is licensed to practice in California (license number 95006058) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1942740899.
Physician's Profile
| Full Name | Kenneth Phong |
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| Gender | Male |
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| Speciality | Nurse Practitioner - Family |
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| Location | 757 Westwood Plz, Los Angeles, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1942740899
- Provider Enumeration Date: 02/26/2017
- Last Update Date: 10/29/2025
Medicare PECOS Information:
- PECOS PAC ID: 7618242520
- Enrollment ID: I20171003005761
Medical Identifiers
Medical identifiers for Kenneth Phong such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1942740899 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207RH0003X | Internal Medicine - Hematology & Oncology | 95006058 (California) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 95006058 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenneth Phong is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Kenneth Phong, NP 5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631 Ph: () - | Kenneth Phong, NP 757 Westwood Plz, Los Angeles, CA 90095-8358 Ph: (310) 825-6301 |
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