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General NPI Number Information
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NPI Number | 1184981565
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Entity Type | Individual
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Provider Name | MYEEKYUNG KANG
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Gender | Female
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 04/23/2012
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Provider Practice Location Address
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Address Line | 300 S HIGHLAND SPRINGS AVE SUITE 9
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City | BANNING
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State | CA
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Zip | 92220-6504
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Country | US
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Telephone | 951-769-1285
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Fax | 951-769-1594
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Provider Business Mailing Address
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Address Line | 9550 FREMONT AVE APT H5
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City | MONTCLAIR
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State | CA
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Zip | 91763-2315
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Country | US
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Telephone | 310-800-0489
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 66085
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License Number State | CA
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