Individual provider Active NPI

Kimberly Trang Banh, PA-C

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1386370294
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61422 Issued in CA
Practice address
8008 Frost St Ste 300
San Diego, CA 92123-4230
Phone
(858) 939-7471
Fax
(858) 939-7472
NPI assigned
Jul 25, 2022
Last updated
Nov 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61422 CA Primary

Addresses

Primary practice location

8008 Frost St Ste 300
San Diego, CA 92123-4230

Mailing address

8008 Frost St Ste 300
San Diego, CA 92123-4230
Phone (858) 939-7471

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241219001933 CA Practitioner - Physician Assistant 2365979093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Diego Cardiovascular and Thoracic Surgeons IncGroup PAC ID 2264335702, 14 clinicians

Practice addresses (Care Compare)

8008 Frost St
Suite 300
San Diego, CA 92123-4230
Phone (858) 939-7471

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
61422CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
PA61422CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mismo Dermatology Group Apc CurrentSince Dec 29, 2022 Accepting new patients
San Diego Cardiovascular and Thoracic Surgeons, Inc. CurrentSince Aug 8, 2025 Accepting new patients

Locations

6280 Jackson Dr
Ste 9
San Diego, CA 92119
Phone (619) 303-3642

8008 Frost St
Ste 300
San Diego, CA 92123
Phone (858) 939-7471

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1386370294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8008 FROST ST STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234230",
            "telephone_number": "858-939-7471",
            "fax_number": "858-939-7472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8008 FROST ST STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234230",
            "telephone_number": "858-939-7471",
            "fax_number": "858-939-7472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANH",
        "first_name": "KIMBERLY",
        "middle_name": "TRANG",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-25",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA61422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.