Individual provider Active NPI

Jennifer L Scott Kang, PA

  • Physician Assistant
  • Pomona, CA
National Provider Identifier
1720751738
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
309 E 2ND St
Pomona, CA 91766-1854
Phone
(909) 623-6116
NPI assigned
Jul 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

309 E 2ND St
Pomona, CA 91766-1854

Mailing address

309 E 2ND St
Pomona, CA 91766-1854

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
I20221212002736 CA Practitioner - Physician Assistant 4981073061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1855 S Centre City Pkwy
Suite 1885B
Escondido, CA 92025-6525
Phone (442) 203-4936

2484 Vista Way
2484A
Oceanside, CA 92054-6199
Phone (760) 421-5577

2671 Blanding Ave
Suite a
Alameda, CA 94501-1587
Phone (510) 694-4816

2690 5TH St
Suite B
Alameda, CA 94501-6584
Phone (510) 439-9447

6971 El Camino Real
Suite 101
Carlsbad, CA 92009-4114
Phone (760) 258-4971

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Medical Group of California PC CurrentSince Oct 1, 2022 Accepting new patients

Locations

2690 5th St
Ste B
Alameda, CA 94501
Phone (510) 439-9447

6971 El Camino Real
Ste 101
Carlsbad, CA 92009
Phone (760) 258-4971

11971 Central Ave
Ste B
Chino, CA 91710
Phone (909) 310-1488

3955 Bedford Canyon Rd
Unit 103
Corona, CA 92883
Phone (951) 293-4722

1998 Market St
San Francisco, CA 94102
Phone (415) 651-3558

2944 Tapo Canyon Rd
Ste A
Simi Valley, CA 93063
Phone (805) 306-5990

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": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1720751738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E 2ND ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917661854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E 2ND ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917661854",
            "telephone_number": "909-623-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT KANG",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-26",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.