=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588766604
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | THOMAS SUNIL KANG MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2006
-----------------------------------------------------
Last Update Date | 03/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2506 E VISTOSO COMMERCE LOOP STE 180
-----------------------------------------------------
City | ORO VALLEY
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85755-9114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 520-775-3333
-----------------------------------------------------
Fax | 520-775-3334
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 43160
-----------------------------------------------------
City | TUCSON
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85733-3160
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 520-722-3777
-----------------------------------------------------
Fax | 520-296-6224
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207YX0901X
-----------------------------------------------------
Taxonomy Name | Otology & Neurotology Physician
-----------------------------------------------------
License Number | 33713
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------