MEDICARE: DR. JOSEPH INSUNG KANG JR. M.D., PH.D.

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	2085R0001X	Radiation Oncology Physician	A112375	CA
2	390200000X	Student in an Organized Health Care Education/Training Program

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A112375	OTHER	CA	THE MEDICAL BOARD OF CALIFORNIA

General Provider Information

NPI Number	:	1730354929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH INSUNG KANG JR. M.D., PH.D.

Provider Business Mailing Address
First Line	:	11234 ANDERSON ST
Second Line	:	ROOM B121
City	:	LOMA LINDA
State	:	CA
Zip	:	92354-2804
Country	:	US
Telephone Number	:	909-552-8056
Fax Number	:	909-552-4829

Provider Business Practice Location Address
First Line	:	11234 ANDERSON ST
Second Line	:	ROOM B121
City	:	LOMA LINDA
State	:	CA
Zip	:	92354-2804
Country	:	US
Telephone Number	:	909-552-8056
Fax Number	:	909-552-4829

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

Provider Enumeration Date	:	04/28/2008
Last Update Date	:	02/17/2026

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