Individual provider Active NPI

Benjamin Kang, D.C.

  • Chiropractor
  • Artesia, CA
National Provider Identifier
1063672004
Registry record updated Oct 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC24437 Issued in CA
Practice address
11867 Artesia Blvd
Artesia, CA 90701-4002
Phone
(562) 879-3856
Fax
(562) 809-7714
NPI assigned
Jun 12, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC24437 CA Primary
Acupuncturist 171100000X AC3608 CA

Addresses

Primary practice location

11867 Artesia Blvd
Artesia, CA 90701-4002

Mailing address

11867 Artesia Blvd
Artesia, CA 90701
Phone (562) 879-3856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090325000605 CA Practitioner - Chiropractic 9436216074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14519 Main St
Suite B
Hesperia, CA 92345-3380
Phone (562) 879-3856

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC24437CAMDChiropractor
AC3608CAMDAcupuncturist
24437CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Myung Sang Medical Center Chiropractor Past Accepting new patients
Life University Health Center Past Accepting new patients

Organizations & group practices 3

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": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507248000000",
    "number": "1063672004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11867 ARTESIA BLVD",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "90701",
            "telephone_number": "562-879-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11867 ARTESIA BLVD",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907014002",
            "telephone_number": "562-879-3856",
            "fax_number": "562-809-7714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2017-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC24437",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC3608",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Artesia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.