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NPI Code Detail

MEDICARE: DANA BAE KANG MD

MEDICARE: DANA BAE 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
1174400000XSpecialistA97267CA

General Provider Information

NPI Number : 1982803813
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA BAE KANG MD
Provider Business Mailing Address
First Line : 100 N SANTA ANITA AVE
Second Line :
City : ARCADIA
State : CA
Zip : 91006-3108
Country : US
Telephone Number : 626-821-5998
Fax Number :
Provider Business Practice Location Address
First Line : 100 N SANTA ANITA AVE
Second Line :
City : ARCADIA
State : CA
Zip : 91006-3108
Country : US
Telephone Number : 626-821-5998
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2007
Last Update Date : 12/20/2011

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