Individual provider Active NPI

Patricia Phuoc Dang, D.O.

  • Internal Medicine Physician
  • Loma Linda, CA
National Provider Identifier
1265605042
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A11052 Issued in CA
Practice address
11234 Anderson St
House Staff Office CP 21005
Loma Linda, CA 92354-2804
Phone
(909) 558-8131
NPI assigned
Apr 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A11052 CA Primary

Addresses

Primary practice location

11234 Anderson St
House Staff Office CP 21005
Loma Linda, CA 92354-2804

Mailing address

11234 Anderson St
Loma Linda, CA 92354-2804

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
I20110728000217 CA Practitioner - HospitalistPractitioner - Internal Medicine 0547438020 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A11052CAMDInternal Medicine Physician
11052CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Oct 1, 2022 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Oct 1, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 11, 2022 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Loma Linda University Physicians Medical Group Inc Internal Medicine Past Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

11234 Anderson St
Ofc Cp
Loma Linda, CA 92350
Phone 9095584000 ext. 88131

11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890

11370 Anderson St
Ste 31503625
Loma Linda, CA 92354
Phone (909) 558-2191

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: pdang6322@direct.llu.edu

Organizations & group practices 11

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1265605042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "HOUSE STAFF OFFICE CP 21005",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANG",
        "first_name": "PATRICIA",
        "middle_name": "PHUOC",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-11",
        "last_updated": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A11052",
            "primary": true
        }
    ],
    "identifiers": [],
    "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": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.