Organization Active NPI

John C. Kang, MD, a Professional Corporation

  • Surgery Physician
  • Fullerton, CA
National Provider Identifier
1669870473
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A84086 Issued in CA
Legal business name
JOHN C. KANG, MD, A PROFESSIONAL CORPORATION
Practice address
1401 S Brookhurst Rd
Suite 111
Fullerton, CA 92833-4471
Phone
(714) 626-0301
Fax
(323) 373-1555
NPI assigned
Dec 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Choongwha Kang, M.D.
Title
President
Phone
(323) 373-1222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X A84086 CA Primary

Addresses

Primary practice location

1401 S Brookhurst Rd
Suite 111
Fullerton, CA 92833-4471

Mailing address

3130 W Olympic Blvd
Suite 340
Los Angeles, CA 90006-2484
Phone (323) 373-1222

National Provider Directory

National Provider Directory
Tax ID family
John C Kang MD a Professional Corporation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1401 S Brookhurst Rd
Ste 111
Fullerton, CA 92833
Phone (714) 626-0301

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1418169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418169600000",
    "number": "1669870473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 W OLYMPIC BLVD",
            "address_2": "SUITE 340",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062484",
            "telephone_number": "323-373-1222",
            "fax_number": "323-373-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S BROOKHURST RD",
            "address_2": "SUITE 111",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928334471",
            "telephone_number": "714-626-0301",
            "fax_number": "323-373-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN C. KANG, MD, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-10",
        "last_updated": "2014-12-10",
        "status": "A",
        "authorized_official_last_name": "KANG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CHOONGWHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-373-1222",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A84086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.