MEDICARE: WAN SIHK KANG L.AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC7135	CA

General Provider Information

NPI Number	:	1053574251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WAN SIHK KANG L.AC.

Provider Business Mailing Address
First Line	:	3200 INLAND EMPIRE BLVD
Second Line	:	SUITE 275
City	:	ONTARIO
State	:	CA
Zip	:	91764-5513
Country	:	US
Telephone Number	:	909-373-2412
Fax Number	:	909-466-7784

Provider Business Practice Location Address
First Line	:	44105 JACKSON ST
Second Line	:	UNIT B
City	:	INDIO
State	:	CA
Zip	:	92201-3275
Country	:	US
Telephone Number	:	760-863-5432
Fax Number	:	760-863-5492

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2008
Last Update Date	:	07/08/2008

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Directions to “ WAN SIHK KANG L.AC.” Practice Location

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