Active NPI
Connie Kang, PHARMD
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Los Angeles, CA
National Provider Identifier
1861067282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 82483
- Practice address
- 510 S Vermont Ave
Los Angeles, CA 90020-1992 - Phone
- (858) 776-9217
- NPI assigned
- May 26, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 82483 | CA | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 82483 | CA | Primary |
Addresses
Primary practice location
510 S Vermont Ave
Los Angeles, CA 90020-1992
Mailing address
510 S Vermont Ave
Los Angeles, CA 90020-1992
Other practice location 1
26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-4839
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 82483 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661126400000",
"number": "1861067282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 S VERMONT AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900201992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 S VERMONT AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900201992",
"telephone_number": "858-776-9217"
}
],
"practiceLocations": [
{
"address_1": "26520 Cactus Ave",
"address_purpose": "LOCATION",
"city": "Moreno Valley",
"state": "CA",
"postal_code": "925553927",
"country_code": "US",
"telephone_number": "951-486-4839",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KANG",
"first_name": "CONNIE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-26",
"last_updated": "2022-08-22",
"certification_date": "2022-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "82483",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "CA",
"license": "82483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.