Individual provider Active NPI

Karan Ann Kortlander, N.P.

  • Dermatology Physician
  • El Segundo, CA
National Provider Identifier
1174163703
Registry record updated Jan 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
95013412 Issued in CA
Practice address
2284 E Maple Ave
El Segundo, CA 90245-6507
Phone
(818) 468-1806
NPI assigned
Jan 12, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 95013412 CA Primary

Addresses

Primary practice location

2284 E Maple Ave
El Segundo, CA 90245-6507

Mailing address

11633 San Vicente Blvd Ste 230
Los Angeles, CA 90049-6513
Phone (310) 826-3376

Other practice location 1

11633 San Vicente Blvd Ste 230
Los Angeles, CA 90049-6513
Phone (310) 826-3376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95013412CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Stephen Dye, M.D. Apc PastSince Jan 19, 2020 Accepting new patients
James H.Sternberg, M.D. a Medical Corporation Dermatology PastSince Jan 19, 2020 Accepting new patients

Organizations & group practices 2

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": "1578787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579392000000",
    "number": "1174163703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11633 SAN VICENTE BLVD STE 230",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496513",
            "telephone_number": "310-826-3376",
            "fax_number": "310-826-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2284 E MAPLE AVE",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902456507",
            "telephone_number": "818-468-1806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11633 San Vicente Blvd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900496513",
            "country_code": "US",
            "telephone_number": "310-826-3376",
            "fax_number": "310-826-3370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORTLANDER",
        "first_name": "KARAN",
        "middle_name": "ANN",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-12",
        "last_updated": "2020-01-19",
        "certification_date": "2020-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "95013412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.