Healthcare Provider Details

I. General information

NPI: 1588766604
Provider Name (Legal Business Name): THOMAS SUNIL KANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2506 E VISTOSO COMMERCE LOOP STE 180
ORO VALLEY AZ
85755-9114
US

IV. Provider business mailing address

PO BOX 43160
TUCSON AZ
85733-3160
US

V. Phone/Fax

Practice location:
  • Phone: 520-775-3333
  • Fax: 520-775-3334
Mailing address:
  • Phone: 520-722-3777
  • Fax: 520-296-6224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License Number33713
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: