Organization Active NPI

Alison Kang MD Dermatology Inc

  • Dermatology Physician
  • Yorba Linda, CA
National Provider Identifier
1356125652
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ALISON KANG MD DERMATOLOGY INC
Practice address
18256 Imperial Hwy
Yorba Linda, CA 92886-3411
Phone
(714) 695-5717
Fax
(714) 276-2635
NPI assigned
Aug 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Authorized official

Name
Alison Kang, MDNPI 1770967382
Title
MD
Phone
(714) 695-5717

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

18256 Imperial Hwy
Yorba Linda, CA 92886-3411

Mailing address

18256 Imperial Hwy
Yorba Linda, CA 92886-3411
Phone (714) 695-5717

Other names 1

  • Prestige Cosmetic Dermatology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231006002514 CA Part B Supplier - Clinic/Group Practice 7315392685 Receives reassigned benefits from 1 practitioner
Practice locations: Yorba Linda, CA

National Provider Directory

National Provider Directory

Locations

18256 Imperial Hwy
Yorba Linda, CA 92886
Phone (714) 695-5717

Practitioners & affiliated clinicians

Practitioners 2

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": "1692576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1356125652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18256 IMPERIAL HWY",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863411",
            "telephone_number": "714-695-5717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18256 IMPERIAL HWY",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863411",
            "telephone_number": "714-695-5717",
            "fax_number": "714-276-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALISON KANG MD DERMATOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-20",
        "status": "A",
        "authorized_official_last_name": "KANG",
        "authorized_official_first_name": "ALISON",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "714-695-5717",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Cosmetic Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yorba Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.