NPIMap

Organization Active NPI

Derm Lounge PC

  • Dermatology Physician
  • Anaheim, CA
National Provider Identifier
1962260208
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DERM LOUNGE PC
Practice address
1713 W Katella Ave
Anaheim, CA 92804-6450
Phone
(714) 798-2900
Fax
(949) 216-3232
NPI assigned
Mar 11, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Authorized official

Name
Harris Khan
Title
President
Phone
(714) 337-9393

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X
Procedural Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207NS0135X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

1713 W Katella Ave
Anaheim, CA 92804-6450

Mailing address

PO Box 519
Lake Forest, CA 92609-0519
Phone (714) 798-2900

Other practice location 1

113 Waterworks Way Ste 210
Irvine, CA 92618-3176
Phone (714) 798-2900

Other names 2

  • Derm Lounge Doing business as
  • Derm Lounge PC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240802001571 CA Part B Supplier - Clinic/Group Practice 9133666514 Receives reassigned benefits from 10 practitioners
Practice locations: Anaheim, CA; Irvine, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783641600000",
    "number": "1962260208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 519",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926090519",
            "telephone_number": "714-798-2900",
            "fax_number": "949-216-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713 W KATELLA AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928046450",
            "telephone_number": "714-798-2900",
            "fax_number": "949-216-3232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "113 Waterworks Way Ste 210",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926183176",
            "country_code": "US",
            "telephone_number": "714-798-2900",
            "fax_number": "949-216-3232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DERM LOUNGE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-11",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "HARRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-337-9393"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Derm Lounge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Derm Lounge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Derm Lounge PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.