Individual provider Active NPI

Kimberley Hoang Chan, MD

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1588763585
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A90277 Issued in CA
Practice address
11911 San Vicente Blvd Ste 265
Los Angeles, CA 90049-6634
Phone
(424) 291-2984
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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 A90277 CA Primary

Addresses

Primary practice location

11911 San Vicente Blvd Ste 265
Los Angeles, CA 90049-6634

Mailing address

11911 San Vicente Blvd Ste 265
Los Angeles, CA 90049-6634
Phone (424) 291-2984

Other names 1

  • Kim Le Hoang Former name

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
I20061020000523 CA Practitioner - Internal Medicine 7618974312

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
90277CAMDClinical Social Worker
A90277CAMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: kimberly.chan@818068760952836.direct.elationemr.com

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1588763585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11911 SAN VICENTE BLVD STE 265",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496634",
            "telephone_number": "424-291-2984",
            "fax_number": "310-294-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11911 SAN VICENTE BLVD STE 265",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496634",
            "telephone_number": "424-291-2984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "KIMBERLEY",
        "middle_name": "HOANG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A90277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "HOANG",
            "middle_name": "LE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.