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General NPI Number Information
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NPI Number | 1295246924
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Entity Type | Individual
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Provider Name | SANDY KANG
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Gender | Female
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Dates
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Enumeration Date | 10/20/2017
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Last Update Date | 10/20/2017
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Provider Practice Location Address
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Address Line | 5623 KANAN RD
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City | AGOURA
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State | CA
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Zip | 91301-3358
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Country | US
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Telephone | 818-991-5522
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Fax |
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Provider Business Mailing Address
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Address Line | 5430 E NAPOLEON AVE
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City | OAK PARK
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State | CA
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Zip | 91377-4747
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Country | US
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Telephone | 818-597-1302
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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 | 49976
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License Number State | CA
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