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General NPI Number Information
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NPI Number | 1316698772
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Entity Type | Individual
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Provider Name | PROF. GYUNGSUNG KANG
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Gender | Male
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Dates
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Enumeration Date | 01/17/2022
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Last Update Date | 04/29/2022
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Provider Practice Location Address
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Address Line | 5471 LA PALMA AVE # 203-A
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City | LA PALMA
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State | CA
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Zip | 90623-1745
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Country | US
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Telephone | 714-331-8916
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Fax |
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Provider Business Mailing Address
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Address Line | 5471 LA PALMA AVE # 203-A
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City | LA PALMA
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State | CA
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Zip | 90623-1745
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Country | US
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Telephone | 714-752-6234
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC19199
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License Number State | CA
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