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NPI Code Detail

MEDICARE: DR. RENEE LUCERO KANG DO

MEDICARE:  DR. RENEE LUCERO 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
1207N00000XDermatology Physician20A17953CA

General Provider Information

NPI Number : 1942797543
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RENEE LUCERO KANG DO
Provider Business Mailing Address
First Line : 100 CLOCK TOWER PL STE 250
Second Line :
City : CARMEL
State : CA
Zip : 93923-8775
Country : US
Telephone Number : 831-308-4570
Fax Number : 831-222-1001
Provider Business Practice Location Address
First Line : 100 CLOCK TOWER PL STE 250
Second Line :
City : CARMEL
State : CA
Zip : 93923-8775
Country : US
Telephone Number : 831-308-4570
Fax Number : 831-222-1001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2018
Last Update Date : 01/06/2026

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Directions to “ DR. RENEE LUCERO KANG DO” Practice Location

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