Individual provider Active NPI

Dylan Minh Bach, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Irvine, CA
National Provider Identifier
1629301700
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A 107094 Issued in CA
Practice address
17672 Cowan
Irvine, CA 92614-6027
Phone
(800) 544-4181
Fax
(949) 236-6646
NPI assigned
Sep 8, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A107094 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A 107094 CA Primary

Addresses

Primary practice location

17672 Cowan
Irvine, CA 92614-6027

Mailing address

17672 Cowan
Irvine, CA 92614-6027
Phone (800) 544-4181

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
I20120827000109 CA Practitioner - PathologyPractitioner - General Practice 0547417594 Reassigns benefits to 1 organization
Practice locations: Irvine, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A 107094CAMDAnatomic Pathology & Clinical Pathology Physician
A107094CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Anatomic Pathology & Clinical Pathology CurrentSince Nov 1, 2014 Accepting new patients
University of California Irvine Past Accepting new patients

Locations

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1252368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1629301700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17672 COWAN",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146027",
            "telephone_number": "800-544-4181",
            "fax_number": "949-236-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17672 COWAN",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146027",
            "telephone_number": "800-544-4181",
            "fax_number": "949-236-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACH",
        "first_name": "DYLAN",
        "middle_name": "MINH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-08",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A107094",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A 107094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.