Healthcare Provider Details

I. General information

NPI: 1962715094
Provider Name (Legal Business Name): CHRISTOPHER YOUNG KANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2010
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31862 COAST HWY STE 201
LAGUNA BEACH CA
92651-6771
US

IV. Provider business mailing address

1968 S COAST HWY # 2201
LAGUNA BEACH CA
92651-3681
US

V. Phone/Fax

Practice location:
  • Phone: 310-954-7169
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberA134495
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberQ9839
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: