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

Active since February 22, 2021CLIA 05D0576370 · Certificate of Compliance
23832 ROCKFIELD BLVD STE 210, LAKE FOREST, CA 92630(949) 770-8115(949) 770-2017 Get Directions Write a Review

NPPES record last updated: August 15, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 15, 2024, Feb 22, 2021 (2 updates tracked since 2021).

About Saddleback Dermatology Laser Cosmetic Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SADDLEBACK DERMATOLOGY LASER COSMETIC CENTER (NPI 1396339255) is a healthcare organization registered as a mohs-micrographic surgery in Lake Forest, California and active in the NPI registry since February 2021. The organization holds a CLIA Certificate of Compliance certificate valid through July 19, 2027 and lists Christina M Rock, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1396339255
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameKIM TANG, M.D., INC.
Location Address23832 ROCKFIELD BLVD STE 210Lake Forest, CA 92630-2876
Mailing Address23832 Rockfield Blvd Ste 210Lake Forest, CA 92630-2876 · (949) 770-8115 · Fax (949) 770-2017
Phone(949) 770-8115
Fax(949) 770-2017
Organization SubpartNo
Authorized OfficialChristina M RockOffice Manager · (949) 770-8115
Enumeration DateFebruary 22, 2021
Last NPPES UpdateAugust 15, 20242 updates tracked since enumeration
NPPES CertifiedAugust 15, 2024
✔ NPI 1396339255 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
Definition
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.
23832 ROCKFIELD BLVD STE 210, Lake Forest, CA 92630
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Other Names 1

Doing Business AsSaddleback Dermatology Laser Cosmetic Center

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Saddleback Dermatology Laser Cosmetic Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Saddleback Dermatology Laser Cosmetic Center, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Ira Bell, M.D.
Dermatology
NPI 1336114545
23832 ROCKFIELD BLVD STE 210
Lake Forest, CA 92630
(949) 770-8115
✔ PECOS✔ Accepts MedicareSame address
Kim Tang, M.D.
Dermatology
NPI 1790746147
23832 ROCKFIELD BLVD STE 210
Lake Forest, CA 92630
(949) 770-8115
✔ PECOS✔ Accepts MedicareSame address
Azin Meshkinpour, M.D., M.P.H.
Dermatology
NPI 1205802089
24432 MUIRLANDS BLVD SUITE 219
Lake Forest, CA 92630
(949) 770-8115
✔ PECOS✔ Accepts Medicare0.7 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 05D0576370

Kim Tang MD Inc · Lake Forest, CA
Active · expires Jul 19, 2027
CLIA Number05D0576370
Laboratory TypePhysician Office
Certificate Effective DateJuly 20, 2025
Certificate Expiration DateJuly 19, 2027
Laboratory DirectorKim T. Tang
Laboratory Phone(949) 770-8115
Laboratory LocationKim Tang MD Inc23832 Rockfield Blvd, Ste 210, Lake Forest, CA 92630
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kim Tang, M.D., Inc.'s NPI number?

The NPI number for Kim Tang, M.D., Inc. is 1396339255. It was assigned to this organization in the NPPES registry on February 22, 2021. The provider is doing business as Saddleback Dermatology Laser Cosmetic Center.

Where is Kim Tang, M.D., Inc. located?

Kim Tang, M.D., Inc. is located at 23832 Rockfield Blvd Ste 210, Lake Forest, CA 92630. The listed phone number is (949) 770-8115.

What is Kim Tang, M.D., Inc.'s specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is Kim Tang, M.D., Inc. enrolled in Medicare?

Yes. Kim Tang, M.D., Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kim Tang, M.D., Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Dermatology, reassign their Medicare billing to Kim Tang, M.D., Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Kim Tang, M.D., Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 05D0576370) is associated with this NPI, valid through July 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kim Tang, M.D., Inc. was last updated on August 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.