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General NPI Number Information
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NPI Number | 1881865350
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Entity Type | Individual
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Provider Name | TIM J. KANG L.AC.
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Gender | Male
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Dates
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Enumeration Date | 03/12/2008
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 2000 DWIGHT WAY SUITE A
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City | BERKELEY
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State | CA
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Zip | 94704-2639
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Country | US
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Telephone | 415-680-8620
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Fax |
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Provider Business Mailing Address
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Address Line | 3945 HARRISON ST #3
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City | OAKLAND
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State | CA
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Zip | 94611-4576
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Country | US
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Telephone | 415-680-8620
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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 | 12107
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License Number State | CA
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