Provider Demographics
NPI:1194903278
Name:KANG CHIROPRACTIC INC.
Entity type:Organization
Organization Name:KANG CHIROPRACTIC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:SOO
Authorized Official - Last Name:HA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:626-833-4329
Mailing Address - Street 1:113 WATERWORKS WAY
Mailing Address - Street 2:115
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3171
Mailing Address - Country:US
Mailing Address - Phone:949-727-1772
Mailing Address - Fax:949-727-1782
Practice Address - Street 1:113 WATERWORKS WAY
Practice Address - Street 2:115
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3171
Practice Address - Country:US
Practice Address - Phone:949-727-1772
Practice Address - Fax:949-727-1782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27457111N00000X, 305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No305R00000XManaged Care OrganizationsPreferred Provider OrganizationGroup - Single Specialty