MEDICARE: CHRISTINA KANG DO

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	207RC0000X	Cardiovascular Disease Physician	006763	AZ
2	207RC0000X	Cardiovascular Disease Physician	1017763	MA
3	207RC0000X	Cardiovascular Disease Physician	2023-03344	NC
4	207RC0000X	Cardiovascular Disease Physician	DO01299	RI
5	207RC0000X	Cardiovascular Disease Physician	CDR.0003650	CO
6	207RC0000X	Cardiovascular Disease Physician	98808	GA
7	207RC0000X	Cardiovascular Disease Physician	U9142	TX
8	207RC0000X	Cardiovascular Disease Physician	OP61530444	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417197161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA KANG DO

Provider Business Mailing Address
First Line	:	3815 E BELL RD
Second Line	:	SUITE 3300
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2122
Country	:	US
Telephone Number	:	623-433-0202
Fax Number	:	623-433-0204

Provider Business Practice Location Address
First Line	:	3815 E BELL RD
Second Line	:	SUITE 3300
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2122
Country	:	US
Telephone Number	:	623-433-0202
Fax Number	:	623-433-0204

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

Provider Enumeration Date	:	02/20/2009
Last Update Date	:	03/24/2026

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Directions to “ CHRISTINA KANG DO” Practice Location

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