| Dae-wook Kang, M.d. Professional Corporation | |
|
2000 W. Hedding St. Suite 10 San Jose CA 95128-1426 | |
| (408) 280-5500 | |
| (408) 275-8311 |
| Full Name | Dae-wook Kang, M.d. Professional Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 2000 W. Hedding St., San Jose, California |
| Authorized Official Name and Position | Dae-wook Kang (CEO) |
| Authorized Official Contact | 4082805500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dae-wook Kang, M.d. Professional Corporation 2000 W Hedding St Suite 10 San Jose CA 95128-1426 Ph: (408) 280-5500 | Dae-wook Kang, M.d. Professional Corporation 2000 W. Hedding St. Suite 10 San Jose CA 95128-1426 Ph: (408) 280-5500 |
| NPI Number | 1477736650 |
|---|---|
| Provider Enumeration Date | 12/11/2007 |
| Last Update Date | 03/11/2009 |
| Medicare PECOS PAC ID | 3274614201 |
|---|---|
| Medicare Enrollment ID | O20080116000430 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477736650 | NPI | - | NPPES |
| 00G794860 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | G79486 (California) | Primary |
| Provider Name | Dae-wook Kang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194741272 PECOS PAC ID: 7012098049 Enrollment ID: I20080116000418 |
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