Provider Demographics
NPI:1003898537
Name:KANG, DANNY (OTR)
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:
Last Name:KANG
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 CENTERPOINTE DR
Mailing Address - Street 2:SUITE 115
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-2576
Mailing Address - Country:US
Mailing Address - Phone:714-670-0007
Mailing Address - Fax:714-670-0005
Practice Address - Street 1:9828 GARDEN GROVE BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-1639
Practice Address - Country:US
Practice Address - Phone:714-591-5853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2017-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT10983225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist