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General NPI Number Information
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NPI Number | 1952702458
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Entity Type | Organization
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Legal Business Name | JOHN C. KANG, MD, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/16/2014
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Last Update Date | 09/16/2014
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Provider Practice Location Address
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Address Line | 3130 W OLYMPIC BLVD SUITE 340
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City | LOS ANGELES
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State | CA
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Zip | 90006-2484
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Country | US
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Telephone | 310-431-7902
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 S HOGAN CT
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City | LA HABRA
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State | CA
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Zip | 90631-2070
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Country | US
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Telephone | 310-431-7902
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN CHOONGWHA KANG
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Credential | M.D.
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Telephone | 310-431-7902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | A84086
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A84086
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License Number State | CA
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