Organization Active NPI

Richard J. Kang, MD, Inc.

  • Pediatrics Physician
  • Northridge, CA
National Provider Identifier
1235615741
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A83965 Issued in CA
Legal business name
RICHARD J. KANG, MD, INC.
Practice address
18300 Roscoe Blvd
Northridge, CA 91325-4105
Phone
(818) 885-5349
Fax
(818) 885-5448
NPI assigned
Jul 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Authorized official

Name
Dr. Richard J Kang, MDNPI 1801991872
Title
President
Phone
(818) 419-5627

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X A83965 CA Primary
Pediatric Critical Care Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0203X A83965 CA

Addresses

Primary practice location

18300 Roscoe Blvd
Northridge, CA 91325-4105

Mailing address

9227 Reseda Blvd # 130
Northridge, CA 91324-3137
Phone (818) 419-5627

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240108003244 CA Part B Supplier - Clinic/Group Practice 4981055613 Receives reassigned benefits from 1 practitioner
Practice locations: Northridge, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531785600000",
    "number": "1235615741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9227 RESEDA BLVD # 130",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243137",
            "telephone_number": "818-419-5627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 ROSCOE BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254105",
            "telephone_number": "818-885-5349",
            "fax_number": "818-885-5448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD J. KANG, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-07-17",
        "status": "A",
        "authorized_official_last_name": "KANG",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-419-5627",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A83965",
            "primary": true
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "A83965",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.