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General NPI Number Information
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NPI Number | 1639357056
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Entity Type | Organization
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Legal Business Name | SHIN WOOK KANG MEDICAL CENTER INC
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Dates
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Enumeration Date | 02/07/2008
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Last Update Date | 10/19/2010
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Provider Practice Location Address
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Address Line | 2727 W OLYMPIC BLVD STE 206
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City | LOS ANGELES
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State | CA
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Zip | 90006-2640
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Country | US
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Telephone | 213-380-7077
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Fax |
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Provider Business Mailing Address
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Address Line | 2727 W OLYMPIC BLVD STE 206
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City | LOS ANGELES
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State | CA
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Zip | 90006-2640
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Country | US
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Telephone | 213-380-7077
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHIN W KANG
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Credential |
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Telephone | 213-380-7077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | W15560
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License Number State | CA
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