Individual provider Active NPI

Heidi Pang, DO

  • Family Medicine Physician
  • Panorama City, CA
National Provider Identifier
1790213494
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A17268 Issued in CA
Practice address
14427 Chase St Ste 208
Panorama City, CA 91402-3020
Phone
(818) 830-7751
NPI assigned
May 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A17268 CA Primary

Addresses

Primary practice location

14427 Chase St Ste 208
Panorama City, CA 91402-3020

Mailing address

14427 Chase St Ste 208
Panorama City, CA 91402-3020
Phone (818) 830-7751

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
I20200610001296 CA Practitioner - Family Practice 7214358621 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6041 Cadillac Ave
Los Angeles, CA 90034-1702
Phone (800) 954-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17268CAMDProfessional Counselor
20A17268CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 30, 2024 Accepting new patients
Canyon Springs Medical Group, Inc. Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 30, 2024 Accepting new patients
County of Riverside CurrentSince Jul 1, 2020 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Innovative Medical Solutions Inc a Medical Group CurrentSince Jul 1, 2022 Accepting new patients
County of Riverside CurrentSince Jul 1, 2020 Accepting new patients

Locations

8920 Wilshire Blvd
Ste 310
Beverly Hills, CA 90211
Phone (310) 256-2426

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

26520 Cactus Ave
Rm A1005
Moreno Valley, CA 92555
Phone (951) 486-5914

14860 Roscoe Blvd
Ste 200
Panorama City, CA 91402
Phone (818) 830-7751

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

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: hpang135231@direct.llu.edu

Organizations & group practices 8

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 1

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": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1790213494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14427 CHASE ST STE 208",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914023020",
            "telephone_number": "818-830-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14427 CHASE ST STE 208",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914023020",
            "telephone_number": "818-830-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANG",
        "first_name": "HEIDI",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-25",
        "last_updated": "2024-10-25",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A17268",
            "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": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Panorama City, CA

Sources for this page

Verify at the official NPI Registry.