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NPI Code Detail

MEDICARE: HYUN KANG MD

MEDICARE:   HYUN  KANG  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0200XCritical Care Medicine (Internal Medicine) Physician4301082719MI
2207RC0200XCritical Care Medicine (Internal Medicine) PhysicianC54908CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CA2184OTHERMIRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316917883
Entity Type Code : Individual
Provider Name (Legal Business Name) : HYUN KANG MD
Provider Business Mailing Address
First Line : 1165 MONTGOMERY DR
Second Line :
City : SANTA ROSA
State : CA
Zip : 95405-4801
Country : US
Telephone Number : 707-547-5437
Fax Number : 707-547-5430
Provider Business Practice Location Address
First Line : 1165 MONTGOMERY DR
Second Line :
City : SANTA ROSA
State : CA
Zip : 95405-4801
Country : US
Telephone Number : 707-547-5437
Fax Number : 707-547-5430
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 11/03/2021

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Directions to “ HYUN KANG MD” Practice Location

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