Individual provider Active NPI

Stephen Kang, PHARMD

  • Pharmacist
  • Corona, CA
National Provider Identifier
1902279367
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
70930 Issued in CA
Practice address
215 Deininger Cir
Corona, CA 92878-3207
Phone
(800) 607-6861
NPI assigned
Nov 6, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 70930 CA Primary

Addresses

Primary practice location

215 Deininger Cir
Corona, CA 92878-3207

Mailing address

215 Deininger Cir
Corona, CA 92878-3207
Phone (800) 607-6861

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

LicenseStateTypeSpecialty
70930CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Costco Wholesale Corporation CurrentSince Nov 1, 2021 Accepting new patients
Garfield Beach CVS, L.L.C. Past Accepting new patients

Locations

215 Deininger Cir
Corona, CA 92878
Phone (800) 607-6861

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1446768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1902279367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 DEININGER CIR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928783207",
            "telephone_number": "800-607-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 DEININGER CIR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928783207",
            "telephone_number": "800-607-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "STEPHEN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-06",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "70930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.

Verify at the official NPI Registry.