Santa Cruz Medical Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SANTA CRUZ MEDICAL CLINIC

Practice address

8703 Stonewall Rd
2B
Manassas, VA 20110-8325

Phone

(703) 361-1955

Fax

(703) 361-3277

NPI assigned

Nov 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Byong K Kang, M.D.NPI 1295808137

Title

Dr.

Phone

(703) 361-1955

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Byong Kuk Kang, M.D.

  • Family Medicine Physician
  • Manassas, VA
  • NPI 1295808137
  Medicare reassignment NPD Authorized official
• Bora Jin, PA-C

  • Physician Assistant
  • Manassas, VA
  • NPI 1326155185
  NPD (past)

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1013199348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8703 STONEWALL RD",
            "address_2": "2B",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201108325",
            "telephone_number": "703-361-1955",
            "fax_number": "703-361-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8703 STONEWALL RD",
            "address_2": "2B",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201108325",
            "telephone_number": "703-361-1955",
            "fax_number": "703-361-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA CRUZ MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "KANG",
        "authorized_official_first_name": "BYONG",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "703-361-1955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "C08625",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Sanders
• Renee Ann Sanders
• Yvette C Sandoval, M.D.
• Tabasom Sanjideh, DMD, MMS
• Sandra Evana Sansano Magnani, DDS
• Therrel Santana, LCSW
• Alejandro Santos Leal, M.D.
• Sareen Dentistry DMD PLLC
• Teena Sareen, D.M.D
• Jennifer Sarisky, LCSW

• Family Medicine Physician in Manassas, VA
• Providers in Manassas, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.