South County Kidney and Endocrine Center

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

SOUTH COUNTY KIDNEY AND ENDOCRINE CENTER

Practice address

23141 Moulton Pkwy Ste 102
Laguna Hills, CA 92653-1241

Phone

(949) 916-9100

Fax

(949) 916-0091

NPI assigned

Mar 1, 2017

Last updated

Mar 1, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Raymond Ku Jay Chang

Title

Medical Director

Phone

(949) 916-9100

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1891235578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23141 MOULTON PKWY #102",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "92653",
            "telephone_number": "949-916-9100",
            "fax_number": "949-916-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23141 MOULTON PKWY STE 102",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531241",
            "telephone_number": "949-916-9100",
            "fax_number": "949-916-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COUNTY KIDNEY AND ENDOCRINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "KU JAY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "949-916-9100",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "CA",
            "license": "202278889",
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Public Health or Welfare Agency in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Public Health or Welfare Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.