Kim Tang, M.D., Inc.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

KIM TANG, M.D., INC.

Practice address

23832 Rockfield Blvd Ste 210
Lake Forest, CA 92630-2876

Phone

(949) 770-8115

Fax

(949) 770-2017

NPI assigned

Feb 22, 2021

Organization subpart

No

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

Authorized official

Name

Christina M Rock

Title

Office Manager

Phone

(949) 770-8115

Specialties & licenses 1

Addresses

Other names 1

• Saddleback Dermatology Laser Cosmetic Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 6

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

• Ira Bell, M.D.

  • Dermatology Physician
  • Lake Forest, CA
  • NPI 1336114545
  Medicare reassignment Care Compare group NPD
• Azin Meshkinpour, M.D., M.P.H.

  • Dermatology Physician
  • Lake Forest, CA
  • NPI 1205802089
  Medicare reassignment Care Compare group NPD
• Kim Thu Tang, M.D.

  • Dermatology Physician
  • Lake Forest, CA
  • NPI 1790746147
  Medicare reassignment Care Compare group NPD
• Yen Thi Lu, PA

  • Medical Physician Assistant
  • Lake Forest, CA
  • NPI 1538779939
  Medicare reassignment Care Compare group
• Kim Phan, PA-C

  • Physician Assistant
  • Irvine, CA
  • NPI 1043934706
  Medicare reassignment Care Compare group
• Karen Benik, M.D.

  • Dermatology Physician
  • Lake Forest, CA
  • NPI 1447226386
  NPD

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1396339255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23832 ROCKFIELD BLVD STE 210",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302876",
            "telephone_number": "949-770-8115",
            "fax_number": "949-770-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23832 ROCKFIELD BLVD STE 210",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302876",
            "telephone_number": "949-770-8115",
            "fax_number": "949-770-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM TANG, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-22",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A",
        "authorized_official_last_name": "ROCK",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "949-770-8115"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saddleback Dermatology Laser Cosmetic Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Saddleback Dermatology Laser Cosmetic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Omid Khodai, O.D.
• Ramin Khoshsar, D.M.D.
• Jacklen Jamel Khuri
• Richard A Kidder, OPTOMETRIST
• James Edward Kilday, MS, OTR/L
• Kim Yen Nguyen DDS Inc
• Elizabeth Ga Yeun Kim, D.D.S.
• Ji Yun Kim
• Jung-Joo Kim, D.C.
• Sean Kim, D.D.S.

• MOHS-Micrographic Surgery Physician in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• MOHS-Micrographic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.