| Soo Woong Kang Md Inc | |
|
11832 Rosecrans Ave 127 Norwalk CA 90650-4107 | |
| (562) 868-6256 | |
| Not Available |
| Full Name | Soo Woong Kang Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11832 Rosecrans Ave, Norwalk, California |
| Authorized Official Name and Position | Soo Woong Kang (DIRECTOR) |
| Authorized Official Contact | 5628686256 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soo Woong Kang Md Inc 11832 Rosecrans Ave 127 Norwalk CA 90650-4107 Ph: (562) 868-6256 | Soo Woong Kang Md Inc 11832 Rosecrans Ave 127 Norwalk CA 90650-4107 Ph: (562) 868-6256 |
| NPI Number | 1689880593 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 02/22/2008 |
| Medicare PECOS PAC ID | 2466548110 |
|---|---|
| Medicare Enrollment ID | O20071011000316 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689880593 | NPI | - | NPPES |
| 00A666300 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 00A66630 (California) | Primary |
| Provider Name | Soo W Kang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164577706 PECOS PAC ID: 2567558216 Enrollment ID: I20071011000307 |
| Provider Name | Jieun Fnp Sim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932601952 PECOS PAC ID: 8123373685 Enrollment ID: I20180625001368 |
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