MEDICARE: DR. NICOLAS ALEXANDER 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
1	207R00000X	Internal Medicine Physician	A200326	CA

General Provider Information

NPI Number	:	1851971576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLAS ALEXANDER KANG MD

Provider Business Mailing Address
First Line	:	2880 ATLANTIC AVE STE 110
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-1739
Country	:	US
Telephone Number	:	562-492-9900
Fax Number	:	562-492-9902

Provider Business Practice Location Address
First Line	:	2880 ATLANTIC AVE STE 230
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-1735
Country	:	US
Telephone Number	:	562-492-9900
Fax Number	:	562-492-9902

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

Provider Enumeration Date	:	04/08/2021
Last Update Date	:	02/20/2026

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