Individual
BUMIN KONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
558 SAINT CHARLES DR STE 200, THOUSAND OAKS, CA 91360-3968
(805) 379-2322
Mailing address
1001 NEWBURY RD, THOUSAND OAKS, CA 91320-6434
(805) 379-2322
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
A178290
CA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
A178290
CA
Other
Enumeration date
03/23/2020
Last updated
04/02/2026
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