Mina Rim Kang, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

A114952 Issued in CA

Practice address

2121 Santa Monica Blvd
Santa Monica, CA 90404-2303

Phone

(310) 453-1324

Fax

(424) 212-5921

NPI assigned

Jul 6, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: mkang473451@oc.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Providence Facey Medical Foundation

  • Internal Medicine Physician
  • Valencia, CA
  • NPI 1710031588
  Medicare reassignment NPD
• Providence Saint Johns Medical Foundation

  • Specialist
  • Santa Monica, CA
  • NPI 1770093734

  Internal Medicine

  Medicare reassignment NPD
• Providence Facey Medical Foundation

  • Multi-Specialty Clinic/Center
  • Irvine, CA
  • NPI 1891348447
  NPD
• Providence Saint John'S Health Center

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1124026273
  NPD (past)
• UCLA Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1043427248
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1003045600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 SANTA MONICA BLVD",
            "address_2": "PROVIDENCE ST. JOHN'S HEALTH CENTER",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042303",
            "telephone_number": "310-829-8858",
            "fax_number": "424-212-5921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 SANTA MONICA BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042303",
            "telephone_number": "310-453-1324",
            "fax_number": "424-212-5921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "MINA",
        "middle_name": "RIM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-06",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A114952",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A114952",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A114952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkang473451@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2121 Santa Monica Blvd",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904042303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tsuneo Kaneko
• Lewis Ringel Kanengiser, M.D.
• Daniel Won Kang, MD,MPH
• Dong Su Kang, LAC
• Jeanney Kang
• Patty Kang, PHARMD
• Soo Yeon Kelly Kang, M.D,
• Stephen John Kania, M.D.
• Laura Merlyn Kanofsky, LCSW
• Valerie Kanter, DMD

• Hospitalist Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Hospitalist Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.