Healthcare Provider Details

I. General information

NPI: 1851320162
Provider Name (Legal Business Name): STEVEN KANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 HAWTHORNE AVE #201
OAKLAND CA
94609-3107
US

IV. Provider business mailing address

PO BOX 276950
SACRAMENTO CA
95827-6950
US

V. Phone/Fax

Practice location:
  • Phone: 510-452-1345
  • Fax: 510-452-1102
Mailing address:
  • Phone: 510-452-1345
  • Fax: 510-452-1102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA72811
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberA72811
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: