Healthcare Provider Details

I. General information

NPI: 1942467097
Provider Name (Legal Business Name): MISS JI HYUN KANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JI HYUN KANG RPH

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 S HAVANA ST
AURORA CO
80012-4019
US

IV. Provider business mailing address

1155 S HAVANA ST
AURORA CO
80012-4019
US

V. Phone/Fax

Practice location:
  • Phone: 720-988-8387
  • Fax: 303-743-1454
Mailing address:
  • Phone: 720-988-8387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number13694
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: