Individual provider Active NPI

Xin Kang, M.D.

  • Psychiatry Physician
  • Cerritos, CA
National Provider Identifier
1053458166
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A88134 Issued in CA
Practice address
17707 Studebaker Rd # Hct4100
Cerritos, CA 90703-2640
Phone
(562) 402-0688
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A88134 CA Primary

Addresses

Primary practice location

17707 Studebaker Rd # Hct4100
Cerritos, CA 90703-2640

Mailing address

17707 Studebaker Rd
Cerritos, CA 90703-2640
Phone (562) 402-0688

Other practice location 1

9353 Valley Blvd
Rosemead, CA 91770-1923
Phone (626) 287-2988

Other identifiers 1

IdentifierTypeStateIssuer
A88134OtherCASTATE LIC NUMBER

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070410000677 CA Practitioner - Psychiatry 6507961166 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific ClinicsGroup PAC ID 4082008420, 72 clinicians

Practice addresses (Care Compare)

1020 S Arroyo Pkwy
Pasadena, CA 91105-3911
Phone (626) 403-2794

9353 Valley Blvd
Rosemead, CA 91770-1923
Phone (626) 287-2988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A88134CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Clinics CurrentSince Mar 1, 2022 Accepting new patients
Los Angeles County Department of Mental Health Current Accepting new patients
Pacific Clinics CurrentSince Mar 1, 2022 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Dec 9, 2012 Accepting new patients
Pacific Clinics Current Accepting new patients

Locations

800 S Santa Anita Ave
Arcadia, CA 91006
Phone (626) 254-5043

330 E Live Oak Ave
Arcadia, CA 91006
Phone (626) 254-1400

251 Llewellyn Ave
Campbell, CA 95008
Phone (408) 364-4083

17707 Studebaker Rd
#4100
Cerritos, CA 90703
Phone (562) 402-0688

17707 Studebaker Rd
Cerritos, CA 90703
Phone (562) 402-0688

17707 Studebaker Rd
#150
Cerritos, CA 90703
Phone (310) 402-0688

1359 N Grand Ave
Covina, CA 91724
Phone (626) 430-2900

1359 N Grand Ave
Fl 1
Covina, CA 91724
Phone (626) 430-2900

10515 Balboa Blvd
Granada Hills, CA 91344
Phone (818) 486-3837

349A E Avenue K6
Lancaster, CA 93535
Phone (661) 723-4260

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

550 S Vermont Ave
Fl 6
Los Angeles, CA 90020
Phone (213) 351-7284

1020 S Arroyo Pkwy
Pasadena, CA 91105
Phone (626) 403-2794

9353 Valley Blvd
Rosemead, CA 91770
Phone (626) 287-2988

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1053458166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17707 STUDEBAKER RD",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032640",
            "telephone_number": "562-402-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17707 STUDEBAKER RD # HCT4100",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032640",
            "telephone_number": "562-402-0688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9353 Valley Blvd",
            "address_purpose": "LOCATION",
            "city": "Rosemead",
            "state": "CA",
            "postal_code": "917701923",
            "country_code": "US",
            "telephone_number": "626-287-2988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "XIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A88134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC NUMBER",
            "identifier": "A88134",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

Verify at the official NPI Registry.