Individual provider Active NPI

Christopher Li-Han Dang, M.D.

  • Psychiatry Physician
  • Bakersfield, CA
National Provider Identifier
1669731964
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A127265 Issued in CA
Practice address
1700 Mount Vernon Ave
Bakersfield, CA 93306-4018
Phone
(661) 326-5411
NPI assigned
May 8, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A127265 CA Primary

Addresses

Primary practice location

1700 Mount Vernon Ave
Bakersfield, CA 93306-4018

Mailing address

780 Shadowridge Dr
Vista, CA 92083-7986
Phone (760) 599-6466

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151105002814 CA Practitioner - Psychiatry 1052621810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2011
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)

360 Rush Dr
San Marcos, CA 92078-7901
Phone (833) 574-2273

4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000

780 Shadowridge Dr
Vista, CA 92083-7986
Phone (619) 528-5000

Hospital & facility affiliations

  • Kaiser Foundation Hospital - San Marcos Hospital, San Marcos, CA, CCN 050855
  • Kaiser Foundation Hospital - San Diego Hospital, San Diego, CA, CCN 050515

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A127265CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 14, 2015 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 14, 2015 Accepting new patients

Locations

393 E Walnut St
Pasadena, CA 91188
Phone (626) 405-7914

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

780 Shadowridge Dr
Vista, CA 92083
Phone (760) 599-2350

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1669731964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 SHADOWRIDGE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920837986",
            "telephone_number": "760-599-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 MOUNT VERNON AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933064018",
            "telephone_number": "661-326-5411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANG",
        "first_name": "CHRISTOPHER",
        "middle_name": "LI-HAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-08",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A127265",
            "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": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.