Individual provider Active NPI

Lynn Ngo Kihara, M.D.

  • Obstetrics & Gynecology Physician
  • San Diego, CA
National Provider Identifier
1063726933
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A119426 Issued in CA
Practice address
4405 Vandever Ave
San Diego, CA 92120-3315
Phone
(619) 516-6606
NPI assigned
Aug 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 258634 MA
Obstetrics & Gynecology Physician 207V00000X A119426 CA Primary

Addresses

Primary practice location

4405 Vandever Ave
San Diego, CA 92120-3315

Mailing address

1620 Tremont St
Obc 3-34
Boston, MA 02120-1613
Phone (617) 732-8798

Other identifiers 1

IdentifierTypeStateIssuer
110100040MedicaidMA

Other names 1

  • Lynn Ly Ngo Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20180529001948 CA Practitioner - Obstetrics/Gynecology 1355569260 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A119426CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Apr 15, 2018 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 15, 2018 Accepting new patients

Locations

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

4405 Vandever Ave
San Diego, CA 92120
Phone (619) 516-6223

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

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": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1063726933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 TREMONT ST",
            "address_2": "OBC 3-34",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021201613",
            "telephone_number": "617-732-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 VANDEVER AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921203315",
            "telephone_number": "619-516-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIHARA",
        "first_name": "LYNN",
        "middle_name": "NGO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "258634",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A119426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110100040",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LYNN",
            "last_name": "NGO",
            "middle_name": "LY",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.