Individual provider Active NPI

Cong Ran

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Santa Monica, CA
National Provider Identifier
1194110700
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
A167718 Issued in CA
Practice address
1317 5TH St Ste 300
Santa Monica, CA 90401-1433
Phone
(310) 434-0044
NPI assigned
Mar 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X A167718 CA
Student in an Organized Health Care Education/Training Program 390200000X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X A167718 CA Primary

Addresses

Primary practice location

1317 5TH St Ste 300
Santa Monica, CA 90401-1433

Mailing address

PO Box 7001
Tarzana, CA 91357-7001
Phone (818) 888-7815

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
I20210510001608 CA Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 7719277797 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Geisel School of Medicine at Dartmouth, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geoffrey Trenkle DO a Professional Medical CorporationGroup PAC ID 1759607310, 17 clinicians

Practice addresses (Care Compare)

103 S Locust St
Inglewood, CA 90301-1812
Phone (323) 306-9632

1300 N Vermont Ave
Suite 605
Los Angeles, CA 90027-6088
Phone (323) 593-7682

1414 S Grand Ave
Suite 123
Los Angeles, CA 90015-3071
Phone (213) 977-1215

1700 E Cesar E Chavez Ave
Suite 2500
Los Angeles, CA 90033-2434
Phone (323) 268-6731

18546 Roscoe Blvd
Suite 200
Northridge, CA 91324-5453
Phone (323) 306-9632

41250 12TH St W
Suite C
Palmdale, CA 93551-1444
Phone (323) 268-6731

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A167718CAMDFacial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geoffrey Trenkle DO a Professional Medical Corporation Otolaryngology CurrentSince Jul 20, 2024 Accepting new patients
Mark Youssef a Medical Corporation Otolaryngology CurrentSince Apr 1, 2021 Accepting new patients
Employee Medical Consultants PC Past Accepting new patients
Samir a Shah MD Professional Corporation Past Accepting new patients
Citrus Valley Medical Associates, Inc. PastSince Aug 2, 2021 Accepting new patients
Arman Torbati DDS PastSince Mar 14, 2020 Accepting new patients
Michael R. Gatto MD, Inc. Otolaryngology PastSince Aug 1, 2007 Accepting new patients

Locations

488 E Santa Clara St
Ste 202
Arcadia, CA 91006

1820 Fullerton Ave
Ste 115
Corona, CA 92881
Phone (951) 817-5000

1577 E Chevy Chase Dr
Ste 330
Glendale, CA 91206
Phone (818) 553-8013

14650 Aviation Blvd
Ste 100
Hawthorne, CA 90250
Phone (310) 725-8505

14650 Aviation Blvd
Ste 200
Hawthorne, CA 90250
Phone (310) 539-2300

3268 E Gage Ave
Huntington Pk, CA 90255
Phone (323) 238-3324

103 S Locust St
Inglewood, CA 90301
Phone (310) 412-3277

1045 Atlantic Ave
Ste 505
Long Beach, CA 90813
Phone (562) 437-0996

1300 N Vermont Ave
Ste 605
Los Angeles, CA 90027
Phone (213) 662-8194

1414 S Grand Ave
Ste 123
Los Angeles, CA 90015
Phone (213) 455-8448

1700 E Cesar E Chavez Ave
Ste 2500
Los Angeles, CA 90033
Phone (323) 268-6731

3737 Martin Luther King Jr Blvd
#403
Lynwood, CA 90262

3737 Martin Luther King Jr Blvd
Ste 403
Lynwood, CA 90262
Phone (310) 635-2223

433 N 4th St
Ste 212
Montebello, CA 90640
Phone (323) 238-3324

18546 Roscoe Blvd
Ste 200
Northridge, CA 91324
Phone (818) 993-1112

1889 N Rice Ave
Ste 201
Oxnard, CA 93030
Phone (805) 600-1550

1180 N Indian Canyon Dr
Ste E311
Palm Springs, CA 92262
Phone (760) 320-4136

41250 12th St W
Ste C
Palmdale, CA 93551
Phone (323) 328-8059

800 Fairmount Ave
Ste 411
Pasadena, CA 91105

1551 Ocean Ave
Ste 200
Santa Monica, CA 90401
Phone (310) 394-0570

1317 5th St
Ste 300
Santa Monica, CA 90401
Phone (310) 434-0044

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1194110700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7001",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913577001",
            "telephone_number": "818-888-7815",
            "fax_number": "818-715-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 5TH ST STE 300",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011433",
            "telephone_number": "310-434-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAN",
        "first_name": "CONG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-31",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "CA",
            "license": "A167718",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "CA",
            "license": "A167718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.