Individual provider Active NPI

Chuong Dinh Dang, M.D.

  • Pediatric Hospice and Palliative Medicine Physician
  • Oakland, CA
National Provider Identifier
1740522408
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hospice and Palliative Medicine PhysicianTaxonomy code 2080H0002X
License
A133239 Issued in CA
Practice address
280 W Macarthur Blvd
RM #1118
Oakland, CA 94611-5642
Phone
(619) 808-4640
NPI assigned
Mar 20, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hospice and Palliative Medicine Physician 2080H0002X A133239 CA Primary

Addresses

Primary practice location

280 W Macarthur Blvd
RM #1118
Oakland, CA 94611-5642

Mailing address

393 E Walnut St
PHR Group Provider Enrollment Unit 3Rd FL
Pasadena, CA 91188-0001
Phone (877) 608-0044

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
I20170907002187 CA Practitioner - Pediatric MedicinePractitioner - Hospice/Palliative Care 7618263419 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
133239CAMDMarriage & Family Therapist
A133239CAMDPediatric Hospice and Palliative Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jul 24, 2017 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 27, 2021 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 24, 2017 Accepting new patients
Kids 1St Pediatrics, Inc. Past Accepting new patients
Riverside Medical Group PC Past Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19886/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/72723
  • Direct secure messaging: chuong.dang.1@19886.direct.athenahealth.com

Organizations & group practices 7

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": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1740522408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 E WALNUT ST",
            "address_2": "PHR GROUP PROVIDER ENROLLMENT UNIT 3RD FL",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911880001",
            "telephone_number": "877-608-0044",
            "fax_number": "877-514-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 W MACARTHUR BLVD",
            "address_2": "RM #1118",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115642",
            "telephone_number": "619-808-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANG",
        "first_name": "CHUONG",
        "middle_name": "DINH",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-20",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "A133239",
            "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": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.