Provider Demographics
NPI:1376633255
Name:KANG, KYONG HI (RPH)
Entity Type:Individual
Prefix:MS
First Name:KYONG
Middle Name:HI
Last Name:KANG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 ARCADIA TER
Mailing Address - Street 2:UNIT 202
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-2353
Mailing Address - Country:US
Mailing Address - Phone:408-390-2705
Mailing Address - Fax:
Practice Address - Street 1:615 ARCADIA TER
Practice Address - Street 2:UNIT 202
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-2353
Practice Address - Country:US
Practice Address - Phone:408-390-2705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20897183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist