Healthcare Provider Details

I. General information

NPI: 1740388008
Provider Name (Legal Business Name): JANE KANG PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 WILSHIRE BLVD. (119)
LOS ANGELES CA
90073
US

IV. Provider business mailing address

12231 POMERING RD
DOWNEY CA
90242-3317
US

V. Phone/Fax

Practice location:
  • Phone: 310-268-3244
  • Fax:
Mailing address:
  • Phone: 562-923-7229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number50656
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: