1740516376 NPI number — HELEN H. KANG, M.D., A PROFESSIONAL MEDICAL CORPORATION

Table of content: (NPI 1740516376)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740516376 NPI number — HELEN H. KANG, M.D., A PROFESSIONAL MEDICAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HELEN H. KANG, M.D., A PROFESSIONAL MEDICAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740516376
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/13/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
520 S VIRGIL AVE
Provider Second Line Business Mailing Address:
SUITE 505
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90020-1416
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
213-388-3550
Provider Business Mailing Address Fax Number:
213-928-4287

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
520 S VIRGIL AVE
Provider Second Line Business Practice Location Address:
SUITE 505
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90020-1416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-388-3550
Provider Business Practice Location Address Fax Number:
213-928-4287
Provider Enumeration Date:
11/02/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KANG
Authorized Official First Name:
HELEN
Authorized Official Middle Name:
HYUN
Authorized Official Title or Position:
C.E.O.
Authorized Official Telephone Number:
213-388-3550

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  A103988 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)