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KORYO HEALTH FOUNDATION
NPI 1093985418
Clinic/Center - Primary Care in Los Angeles, CA

Active since March 03, 2008CLIA 05D0695932 · Waiver
1058 S VERMONT AVE, LOS ANGELES, CA 90006(213) 380-8833(213) 368-6047 Get Directions Write a Review

NPPES record last updated: March 3, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Koryo Health Foundation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KORYO HEALTH FOUNDATION (NPI 1093985418) is a healthcare organization registered as a primary care in Los Angeles, California and active in the NPI registry since March 2008. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Maribel Cervantes, Assistant Administrator, as its authorized official.

NPPES Registry Identity

NPI1093985418
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameKORYO HEALTH FOUNDATION
Location Address1058 S VERMONT AVELos Angeles, CA 90006-2721
Mailing Address1058 S Vermont AveLos Angeles, CA 90006-2721 · (213) 380-8833 · Fax (213) 368-6047
Phone(213) 380-8833
Fax(213) 368-6047
Organization SubpartNo
Authorized OfficialMaribel CervantesAssistant Administrator · (213) 380-8833
Enumeration DateMarch 3, 2008
✔ NPI 1093985418 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
1058 S VERMONT AVE, Los Angeles, CA 90006
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Other Identifiers 1

MedicaidEAP70381FCA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0695932

Koryo Health Foundation · Los Angeles, CA
Active · expires Aug 31, 2026
CLIA Number05D0695932
Laboratory TypeCommunity Clinic
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorDr. Dong Joan Yi
Laboratory Phone(213) 380-8833
Laboratory LocationKoryo Health Foundation2655 W Olympic Blvd Suite101, Los Angeles, CA 90006
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. DONG JOON YI MD
Pediatrics
1058 S VERMONT AVE, 227
LOS ANGELES, CA 90006
Los Angeles County (213) 368-6025
SEEDAY HEARING AID INC
Hearing Instrument Specialist
1058 S VERMONT AVE, SUITE 101
LOS ANGELES, CA 90006
Los Angeles County (213) 368-3600
MR. JOHNNY PARK HAD
Hearing Instrument Specialist
1058 S VERMONT AVE, SUITE 109
LOS ANGELES, CA 90006
Los Angeles County (213) 368-6300
MOON JU KIM N.P.
Nurse Practitioner (Women's Health)
1058 S VERMONT AVE
LOS ANGELES, CA 90006
Los Angeles County (213) 380-8833
SOON M. CHA, M.D., INC.
Obstetrics & Gynecology
1058 S VERMONT AVE, SUITE 204
LOS ANGELES, CA 90006
Los Angeles County (213) 368-6020

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Koryo Health Foundation's NPI number?

The NPI number for Koryo Health Foundation is 1093985418. It was assigned to this organization in the NPPES registry on March 3, 2008.

Where is Koryo Health Foundation located?

Koryo Health Foundation is located at 1058 S Vermont Ave, Los Angeles, CA 90006. The listed phone number is (213) 380-8833.

What is Koryo Health Foundation's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Koryo Health Foundation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0695932) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Koryo Health Foundation was last updated on March 3, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.