Jennifer Channual

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A116489 Issued in CA

Practice address

23521 Paseo de Valencia Ste 102
Laguna Hills, CA 92653

Phone

(949) 520-1815

NPI assigned

Jul 9, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Dermatology

Education

University of California, Irvine, California College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jennifer Channual MD IncGroup PAC ID 8628333978, 8 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Jennifer Channual MD Inc

  • Dermatology Physician
  • Laguna Hills, CA
  • NPI 1710485982

  Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1689986374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23521 PASEO DE VALENCIA STE 102",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23521 PASEO DE VALENCIA STE 102",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "92653",
            "telephone_number": "949-520-1815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 San Miguel Dr Ste 501",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "92660",
            "country_code": "US",
            "telephone_number": "949-720-1170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "360 San Miguel Dr Ste 501",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "92660",
            "country_code": "US",
            "telephone_number": "949-720-1170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23521 Paseo De Valencia Ste 102",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "92653",
            "country_code": "US",
            "telephone_number": "949-520-1815",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23521 Paseo De Valencia Ste 102",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "92653",
            "country_code": "US",
            "telephone_number": "949-520-1815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANNUAL",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A116489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Chang, D.D.S.
• Anna Jingwen Chang
• Chao-Mei Chang, PHARM. D.
• Matthew Nicholas Chang, D.C.
• Michael Lynn Chang, D.O.
• Anna Chao, PHARMD
• Joel Michael Chapen, LCSW
• Olivia Charlton, RD, CDE
• Grace M Chau, NP
• Sandeep Chaudhary, M.D

• Dermatology Physician in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.