Individual provider Active NPI

Sung Chul Yang, MD

  • Nephrology Physician
  • Lancaster, CA
National Provider Identifier
1871562900
Registry record updated Feb 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A43185 Issued in CA
Practice address
1759 W Avenue J
Ste 101
Lancaster, CA 93534-2703
Phone
(661) 948-1388
Fax
(661) 948-1223
NPI assigned
Mar 14, 2006
Last updated
Feb 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A43185 CA Primary

Addresses

Primary practice location

1759 W Avenue J
Ste 101
Lancaster, CA 93534-2703

Mailing address

PO Box 2768
Lancaster, CA 93539-2768
Phone (661) 948-1388

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
I20051108000907 CA Practitioner - Nephrology 3870511876 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Jul 1, 2003 Accepting new patients
Antelope Valley Nephrology Medical Group, Inc. CurrentSince May 13, 2013 Accepting new patients
County of Los Angeles CurrentSince Jul 1, 2003 Accepting new patients
County of Los Angeles Current Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

1108 N Oleander Ave
Compton, CA 90222
Phone (310) 763-2244

123 W Manchester Blvd
Inglewood, CA 90301
Phone (310) 419-5325

1759 W Avenue J
#101
Lancaster, CA 93534
Phone (661) 948-1388

335 E Avenue I
Lancaster, CA 93535
Phone (661) 471-4000

44900 60th St W
Lancaster, CA 93536
Phone (661) 945-8413

212 S Richmond Rd
Ridgecrest, CA 93555
Phone (661) 948-1388

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: sung.yang@direct.davitaphysiciansolutions.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1871562900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2768",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935392768",
            "telephone_number": "661-948-1388",
            "fax_number": "661-948-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1759 W AVENUE J",
            "address_2": "STE 101",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342703",
            "telephone_number": "661-948-1388",
            "fax_number": "661-948-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "SUNG",
        "middle_name": "CHUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A43185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.