Provider Demographics
NPI:1063855245
Name:KANG, ALEX CHUN WON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:CHUN WON
Last Name:KANG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 KILROY AIRPORT WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2494
Mailing Address - Country:US
Mailing Address - Phone:562-308-2758
Mailing Address - Fax:
Practice Address - Street 1:3800 KILROY AIRPORT WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2494
Practice Address - Country:US
Practice Address - Phone:562-308-2758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA661691835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy