Individual provider Active NPI

Ho Sil Kang, R.D.

  • Registered Dietitian
  • San Bernardino, CA
National Provider Identifier
1700130192
Registry record updated Nov 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1006826 Issued in CA
Practice address
2645 Annapolis Cir
San Bernardino, CA 92408-4165
Phone
(909) 783-1187
NPI assigned
Nov 7, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1006826 CA Primary

Addresses

Primary practice location

2645 Annapolis Cir
San Bernardino, CA 92408-4165

Mailing address

2645 Annapolis Cir
San Bernardino, CA 92408-4165
Phone (909) 783-1187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1006826CAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1700130192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 ANNAPOLIS CIR",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924084165",
            "telephone_number": "909-783-1187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 ANNAPOLIS CIR",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924084165",
            "telephone_number": "909-783-1187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "HO SIL",
        "name_prefix": "Ms.",
        "credential": "R.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-07",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1006826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; 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.