SOUTH COUNTY KIDNEY AND ENDOCRINE CENTER (NPI# 1891235578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891235578 |
| Entity Type | Organization |
| Organization Name | SOUTH COUNTY KIDNEY AND ENDOCRINE CENTER |
| Practice Address |
23141 Moulton Pkwy Ste 102 Laguna Hills CA 92653-1241 |
| Mailing Address |
23141 Moulton Pkwy #102 Laguna Hills CA 92653 |
| Practice Telephone | 9499169100 |
| Practice Fax Number | 9499160091 |
| Mailing Telephone | 9499169100 |
| Mailing Fax Number | 9499160091 |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |
| Authorized Official Name | DR. RAYMOND KU JAY CHANG (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9499169100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251K00000X | Public Health or Welfare | 202278889 | CA | Agencies |
| Y | 251K00000X | Public Health or Welfare | Agencies |
| Street Address |
23141 MOULTON PKWY STE 102 |
| City | LAGUNA HILLS |
| State | CA |
| Zip Code | 92653-1241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831144104 | Ku Juey Raymond Chang Inc. | Internal Medicine | 23141 Moulton Pkwy Ste 102, Laguna Hills, CA 92653-1241 | 2006-05-24 |
| 1053962233 | Yaseen Kady | Internal Medicine | 23141 Moulton Pkwy Ste 102, Laguna Hills, CA 92653-1241 | 2019-09-27 |
| 1730644527 | Emily Pham | Physician Assistant | 23141 Moulton Pkwy Ste 102, Laguna Hills, CA 92653-1241 | 2019-02-05 |
| 1447456918 | Keong Moon Joung | Physical Medicine & Rehabilitation | 23141 Moulton Pkwy Ste 102, Laguna Hills, CA 92653-1241 | 2007-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708476 | Nikkie Veyseh | Behavior Technician | 26921 Falling Leaf Dr., Laguna Hills, CA 92653 | 2020-10-24 |
| 1609480425 | Steve Ceja | Behavior Technician | 25201 Paseo De Alicia Suite 110, Laguna Hills, CA 92653 | 2020-08-31 |
| 1467006882 | Kristina Alexa Puno Morales | Dietitian, Registered | 24552 Health Center Drive, Laguna Hills, CA 92653 | 2019-07-25 |
| 1164929626 | Shoreline Consulting Services, Inc. | Clinic/Center | 23010 Lake Forest Drive, Suite B, Laguna Hills, CA 92653 | 2018-04-11 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1831613850 | Stephani A Berg | Physical Medicine & Rehabilitation | 24422 Avenida De La Carlota Suite 190, Laguna Hills, CA 92653 | 2017-08-01 |
| 1497299945 | Stephanie Lyle | Nurse Practitioner | 24221 Calle De Louisa, Suite 400, Laguna Hills, CA 92653 | 2016-12-16 |
| 1053776278 | Meillanny Gladness | Counselor | 23151 Verdugo Dr Ste 203, Laguna Hills, CA 92653 | 2015-12-16 |
| 1912383183 | Pmdca, LLC | Clinical Medical Laboratory | 23297 S Pointe Dr Ste 100, Laguna Hills, CA 92653 | 2015-08-10 |
| 1821486630 | 4mpw, Inc. | Home Health | 23232 Peralta Drive 216, Laguan Hills, CA 92653 | 2014-12-31 |
| Find all providers in zip 92653 | ||||
| Taxonomy Code | 251K00000X |
| Grouping | Agencies |
| Classification | Public Health or Welfare |
| Definition to come... |
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| 1396365003 | Hr Support Inc | Public Health or Welfare | 6143 Mount Diablo Ct, Castro Valley, CA 94552-1948 | 2020-04-22 |
| 1811516610 | Fabian Sanchez | Public Health or Welfare | 1940 Nice Dr Apt 106, Corona, CA 92882-4584 | 2020-04-11 |
| 1528695319 | Central Coast Veterans Associates LLC | Public Health or Welfare | 1890 Diablo Drive, San Luis Obispo, CA 93405-4762 | 2020-03-24 |
| 1548893654 | Transitional Nutrition LLC | Public Health or Welfare | 741 Jackson St, Albany, CA 94706-1134 | 2020-02-17 |
| 1639723760 | Matthew Schultzel Do and Douglas Sullivan PC | Public Health or Welfare | 477 N El Camino Real Ste A308, Encinitas, CA 92024-1350 | 2019-07-26 |
| 1760048086 | Info Line of San Diego | Public Health or Welfare | 3860 Calle Fortunada Ste 101, San Diego, CA 92123-4802 | 2019-05-13 |
| 1629548615 | Mojo Enterprises Inc. | Public Health or Welfare | 1004 Emerson St, Palo Alto, CA 94301-2416 | 2018-12-03 |
| 1790265163 | Genben Lifesciences Corporation | Public Health or Welfare | 6370 Lusk Blvd Ste F205, San Diego, CA 92121 | 2018-08-15 |
| 1215429188 | National Health Foundation | Public Health or Welfare | 515 S Figueroa St Ste 1300, Los Angeles, CA 90071-3300 | 2018-06-05 |
| Find all providers with the same taxonomy | ||||
| City | LAGUNA HILLS |
| Zip Code | 92653 |
Please comment or provide details below to improve the information on SOUTH COUNTY KIDNEY AND ENDOCRINE CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.