Provider Demographics
NPI:1982807558
Name:KANG, SANG YOK (LAC)
Entity type:Individual
Prefix:
First Name:SANG
Middle Name:YOK
Last Name:KANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8540 COMMONWEALTH AVE.
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-3102
Mailing Address - Country:US
Mailing Address - Phone:714-736-0871
Mailing Address - Fax:714-736-0874
Practice Address - Street 1:8540 COMMONWEALTH AVE.
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-3102
Practice Address - Country:US
Practice Address - Phone:714-736-0871
Practice Address - Fax:714-736-0874
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC7750OtherACUPUNCTURIST