Individual provider Active NPI

Lucinda Liu Kohn, M.D.

  • Pediatric Dermatology Physician
  • San Rafael, CA
National Provider Identifier
1346669561
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Dermatology PhysicianTaxonomy code 207NP0225X
License
A142093 Issued in CA
Practice address
5000 Civic Center Dr
San Rafael, CA 94903-4184
Phone
(415) 499-0100
NPI assigned
Apr 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dermatology Physician 207NP0225X A142093 CA Primary

Addresses

Primary practice location

5000 Civic Center Dr
San Rafael, CA 94903-4184

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

12605 E 16th Ave
Aurora, CO 80045-2545
Phone (720) 848-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220426001103 TX Practitioner - Dermatology 7517250871 Reassigns benefits to 1 organization
I20241007000639 CA Practitioner - Pediatric MedicinePractitioner - Dermatology 7517250871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Dermatology
Education
Yale University School of Medicine, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Regents Univ of California UCSFGroup PAC ID 6305160300, 276 clinicians
DHHS PHS Naihs Chinle Comprehensive Health Care FacilityGroup PAC ID 9436062585, 160 clinicians

Practice addresses (Care Compare)

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-1000

Highway 191 and Hospital Rd
Chinle, AZ 86503-8000
Phone 92867470307030

Hospital & facility affiliations

  • Chinle Comprehensive Health Care Facility Hospital, Chinle, AZ, CCN 030084
  • Marinhealth Medical Center Hospital, Greenbrae, CA, CCN 050360

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions520
Removal or shaving of skin growth21
Skin biopsy169

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A142093CAMDPediatric Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Consultants of Marin Inc Dermatology CurrentSince Sep 23, 2024 Accepting new patients
Regents Univ of California UCSF CurrentSince Sep 26, 2024 Accepting new patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility CurrentSince Apr 2, 2024 Accepting new patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility Current Accepting new patients

Locations

75 Rowland Way
Ste 101
Novato, CA 94945
Phone (415) 464-9604

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

5000 Civic Center Dr
San Rafael, CA 94903
Phone (415) 499-0100

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

Organizations & group practices 4

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1346669561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 CIVIC CENTER DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949034184",
            "telephone_number": "415-499-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12605 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452545",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOHN",
        "first_name": "LUCINDA",
        "middle_name": "LIU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "CA",
            "license": "A142093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.