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NPI Code Detail

MEDICARE: CONNIE KANG PHARMD

MEDICARE: CONNIE KANG PHARMD
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
1183500000XPharmacist57312CA

General Provider Information

NPI Number : 1649720871
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONNIE KANG PHARMD
Provider Business Mailing Address
First Line : 535 WATSON DR
Second Line :
City : CLAREMONT
State : CA
Zip : 91711-4817
Country : US
Telephone Number : 909-607-0291
Fax Number :
Provider Business Practice Location Address
First Line : 535 WATSON DR
Second Line :
City : CLAREMONT
State : CA
Zip : 91711-4817
Country : US
Telephone Number : 909-607-0291
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2016
Last Update Date : 10/12/2016

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Directions to “ CONNIE KANG PHARMD” Practice Location

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