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NPI Code Detail

MEDICARE: BRIAN KANG MD

MEDICARE: BRIAN KANG MD
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
1208100000XPhysical Medicine & Rehabilitation PhysicianA175339CA
2208100000XPhysical Medicine & Rehabilitation Physician0101284821VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10101284821OTHERVAMEDICAL LICENSE
2A175339OTHERCAMEDICAL LICENSE

General Provider Information

NPI Number : 1417450263
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN KANG MD
Provider Business Mailing Address
First Line : 220 CAMPUS BLVD STE 320
Second Line :
City : WINCHESTER
State : VA
Zip : 22601-2889
Country : US
Telephone Number : 540-536-5100
Fax Number : 540-536-0235
Provider Business Practice Location Address
First Line : 333 W CORK ST UNIT 230
Second Line :
City : WINCHESTER
State : VA
Zip : 22601-3871
Country : US
Telephone Number : 540-536-1120
Fax Number : 540-536-5139
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2018
Last Update Date : 07/23/2025

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