Provider Demographics
NPI:1225592793
Name:KANG, SUNG-HAE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUNG-HAE
Middle Name:
Last Name:KANG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 VETERAN AVE
Mailing Address - Street 2:WEST MEDICAL BUILDING - CYTOGENETICS LAB (#22-26)
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095
Mailing Address - Country:US
Mailing Address - Phone:310-825-9352
Mailing Address - Fax:
Practice Address - Street 1:10833 LE CONTE AVENUE
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY & LABORATORY MEDICINE
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095
Practice Address - Country:US
Practice Address - Phone:310-794-2252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMTP02012971207SG0203X
CAMTO01010143207SC0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SC0300XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Cytogenetics
No207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular Genetics