Timothy Bang

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

95032634 Issued in CA

Practice address

1201 W la Veta Ave
Orange, CA 92868-4203

Phone

(714) 997-3000

NPI assigned

Oct 22, 2021

Reactivated

Mar 28, 2025

Last updated

Mar 28, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1629732946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 PLATEAU",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926568027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "714-997-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 Plateau",
            "address_purpose": "LOCATION",
            "city": "Aliso Viejo",
            "state": "CA",
            "postal_code": "926568027",
            "country_code": "US",
            "telephone_number": "949-310-8241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANG",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-22",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "deactivation_date": "2025-03-05",
        "reactivation_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95032634",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN95132765",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurene Bandolin, NP
• Oliver Bandonell, CRNA
• Dipti Banerjee, MD
• Shoujit Banerjee
• Soo CHI Bang, PA-C
• Megan Nicole Bangle, LCSW
• Janet Banh
• Jess Banh
• Mai T Banh
• Kimberly Catherine Banks, M.S.

• Pediatric Nurse Practitioner in Orange, CA
• Providers in Orange, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.