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KUNTHY PRUM MD
NPI 1760582738
General Practice in Long Beach, CA

Active since September 22, 2006PECOS EnrolledAccepts Medicare Assignment
1082 REDONDO AVE, LONG BEACH, CA 90804(562) 434-4457(562) 434-4458 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kunthy Prum Md NPPES

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

KUNTHY PRUM MD (NPI 1760582738) is an individual general practice provider in Long Beach, California, licensed in California (A39667) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS and is a graduate of University Of California, Geffen School Of Medicine (1983).

NPPES Registry Identity

NPI1760582738
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameKUNTHY PRUMCredential: MD
Location Address1082 REDONDO AVELong Beach, CA 90804
Mailing Address1082 Redondo AveLong Beach, CA 90804 · (562) 434-4457 · Fax (562) 434-4458
Phone(562) 434-4457
Fax(562) 434-4458
Sole ProprietorNo
Medical School CMSUniversity Of California, Geffen School Of MedicineGraduated 1983
Enumeration DateSeptember 22, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1760582738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in CA · A39667
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
1082 REDONDO AVE, Long Beach, CA 90804
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Other Identifiers 3

Medicaid00A396670CA
Medicare UPINC35507
Medicare ID-Type UnspecifiedA39667

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kunthy Prum Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2466576525
PECOS Enrollment IDI20100826000987
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kunthy Prum reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Nova Care Clinic, Inc
0.3 mi
General Practice
2944 E ANAHEIM ST
Long Beach, CA 90804
  • Reassigned Medicare billing, California enrollment
NPI 1205786621 (562) 599-5777

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Kunthy Prum's NPI number?

The NPI number for Kunthy Prum is 1760582738. It was assigned to this individual provider in the NPPES registry on September 22, 2006.

Where is Kunthy Prum located?

Kunthy Prum practices at 1082 Redondo Ave, Long Beach, CA 90804. The listed phone number is (562) 434-4457.

What is Kunthy Prum's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Kunthy Prum enrolled in Medicare?

Yes. Kunthy Prum is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kunthy Prum's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kunthy Prum reassigns Medicare benefits to Nova Care Clinic, Inc (Long Beach, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kunthy Prum's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kunthy Prum was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.