Individual provider Active NPI

Bryna Pearl Kane, M.D.

  • Procedural Dermatology Physician
  • Long Beach, CA
National Provider Identifier
1831171842
Registry record updated May 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
A37025 Issued in CA
Practice address
3828 Schaufele Ave Ste 300
Long Beach, CA 90808-1793
Phone
(562) 997-1144
Fax
(562) 989-3612
NPI assigned
Nov 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A37025 CA
Procedural Dermatology Physician 207NS0135X A37025 CA Primary

Addresses

Primary practice location

3828 Schaufele Ave Ste 300
Long Beach, CA 90808-1793

Mailing address

3828 Schaufele Ave Ste 300
Long Beach, CA 90808-1793
Phone (562) 997-1144

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
I20090828000614 CA Practitioner - Dermatology 6204864010 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37025CAMDLicensed Psychiatric Technician
A37025CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
J Robert West, M.D., Inc Procedural Dermatology CurrentSince Jan 31, 2023 Accepting new patients

Locations

3828 Schaufele Ave
Ste 300
Long Beach, CA 90808
Phone (562) 997-1144

3828 Schaufele Ave
Long Beach, CA 90808
Phone (657) 241-8990

400 Newport Center Dr
Ste 702
Newport Beach, CA 92660
Phone (949) 644-0101

Organizations & group practices 1

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1831171842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3828 SCHAUFELE AVE STE 300",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081793",
            "telephone_number": "562-997-1144",
            "fax_number": "562-989-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3828 SCHAUFELE AVE STE 300",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081793",
            "telephone_number": "562-997-1144",
            "fax_number": "562-989-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE",
        "first_name": "BRYNA",
        "middle_name": "PEARL",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A37025",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A37025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.