SADDLEBACK DERMATOLOGY LASER COSMETIC CENTER
NPI 1396339255
Dermatology - MOHS-Micrographic Surgery in Lake Forest, CA

NPI Status: Active since February 22, 2021

Contact Information

23832 ROCKFIELD BLVD STE 210
LAKE FOREST, CA
ZIP 92630
Phone: (949) 770-8115
Fax: (949) 770-2017

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  • Organization
  • Dermatology
  • MOHS-Micrographic Surgery
  • CLIA Number: 05D0576370
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 07-19-2027

About SADDLEBACK DERMATOLOGY LASER COSMETIC CENTER

This page provides the complete NPI Profile along with additional information for Saddleback Dermatology Laser Cosmetic Center, a provider established in Lake Forest, California operating as a Dermatology, focusing in mohs-micrographic surgery . The healthcare provider is registered in the NPI registry with number 1396339255 assigned on February 2021. The practitioner's primary taxonomy code is 207ND0101X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Saddleback Dermatology Laser Cosmetic Center. The authorized official of this NPI record is Christina M Rock (Office Manager)

NPI
1396339255
Provider Legal Name
KIM TANG, M.D., INC.
Other Organization Name
SADDLEBACK DERMATOLOGY LASER COSMETIC CENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
23832 ROCKFIELD BLVD STE 210 LAKE FOREST, CA 92630
Location Phone
(949) 770-8115
Location Fax
(949) 770-2017
Mailing Address
23832 ROCKFIELD BLVD STE 210 LAKE FOREST, CA 92630
Mailing Phone
(949) 770-8115
Mailing Fax
(949) 770-2017
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-22-2021
Last Update Date
08-15-2024
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dermatology MOHS-Micrographic Surgery

Taxonomy Code
207ND0101X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

CHRISTINA M ROCK

Authorized Official Title
OFFICE MANAGER
Authorized Official Phone
(949) 770-8115

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D0576370
Facility Type
Physician Office
Certificate Effective Date
July 20, 2025
Certificate Expiration Date
July 19, 2027
Laboratory Director
KIM T. TANG
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Saddleback Dermatology Laser Cosmetic Center after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1396339255, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
6
Unchanged
Pos 5
3
Doubled → 6
Pos 6
3
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
2
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 3 → 6 9 → 18 → 9 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 8 + 6 + 6 + 3 + 1 + 8 + 2 + 1 + 0 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1396339255.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Dermatology
23832 ROCKFIELD BLVD STE 210
LAKE FOREST, CA 92630
Dermatology
23832 ROCKFIELD BLVD STE 210
LAKE FOREST, CA 92630
Dermatology
23832 ROCKFIELD BLVD STE 210
LAKE FOREST, CA 92630

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1396339255, enumerated as an "organization" on February 22, 2021.

The provider is located at 23832 ROCKFIELD BLVD STE 210 LAKE FOREST, CA 92630 and the phone number is (949) 770-8115.

Dermatology with taxonomy code 207ND0101X and a focus in MOHS-Micrographic Surgery.