Healthcare Provider Details

I. General information

NPI: 1164691820
Provider Name (Legal Business Name): TYLER YU-TAI KANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2008
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 NUT TREE RD STE 390
VACAVILLE CA
95687-4100
US

IV. Provider business mailing address

1020 NUT TREE RD STE 390
VACAVILLE CA
95687-4100
US

V. Phone/Fax

Practice location:
  • Phone: 707-624-8000
  • Fax: 707-624-8001
Mailing address:
  • Phone: 707-624-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA81013
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: