Individual provider Active NPI

Tutran Nguyen Dang, PA-C

  • Medical Physician Assistant
  • Woodland Hills, CA
National Provider Identifier
1619152170
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA18778 Issued in CA
Practice address
5995 Topanga Canyon Blvd
Woodland Hills, CA 91367-3623
Phone
(818) 888-7009
NPI assigned
Jan 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA18778 CA Primary

Addresses

Primary practice location

5995 Topanga Canyon Blvd
Woodland Hills, CA 91367-3623

Mailing address

8510 Balboa Blvd Ste 150
Northridge, CA 91325-5810
Phone (818) 637-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20090813000404 CA Practitioner - Physician Assistant 3577617307 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

11001 Sepulveda Blvd
Mission Hills, CA 91345-1413
Phone (818) 838-4000

13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18778CAMDMental Health Counselor
PA18778CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation CurrentSince Aug 1, 2021 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jun 11, 2018 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jun 11, 2018 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 31, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 31, 2023 Accepting new patients
Providence Facey Medical Foundation CurrentSince Aug 1, 2021 Accepting new patients
Lakeside Medical Associates, a Medical Group, Inc. Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

3413 W Pacific Ave
Ste 102
Burbank, CA 91505
Phone (818) 953-4408

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

8510 Balboa Blvd
Ste 150
Northridge, CA 91325
Phone (818) 637-2000

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

Interoperability endpoints

  • Direct secure messaging: tutran.dang.p1@direct.lakeside.nextgenshare.com

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1619152170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8510 BALBOA BLVD STE 150",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255810",
            "telephone_number": "818-637-2000",
            "fax_number": "818-654-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5995 TOPANGA CANYON BLVD",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913673623",
            "telephone_number": "818-888-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANG",
        "first_name": "TUTRAN",
        "middle_name": "NGUYEN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-03",
        "last_updated": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA18778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13652 Cantara St",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914025423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

Verify at the official NPI Registry.