Healthcare Provider Details

I. General information

NPI: 1982807558
Provider Name (Legal Business Name): SANG YOK KANG L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 06/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8540 COMMONWEALTH AVE.
BUENA PARK CA
90621-3102
US

IV. Provider business mailing address

8540 COMMONWEALTH AVE.
BUENA PARK CA
90621-3102
US

V. Phone/Fax

Practice location:
  • Phone: 714-736-0871
  • Fax: 714-736-0874
Mailing address:
  • Phone: 714-736-0871
  • Fax: 714-736-0874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: