Provider Demographics
NPI:1477723096
Name:KAN, IRENE OILIN (MD)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:OILIN
Last Name:KAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:411 N LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-3028
Mailing Address - Country:US
Mailing Address - Phone:714-456-5631
Mailing Address - Fax:714-456-6660
Practice Address - Street 1:101 THE CITY DR S
Practice Address - Street 2:ZOT 4482; PEDIATRICS
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3201
Practice Address - Country:US
Practice Address - Phone:714-456-5631
Practice Address - Fax:714-456-6660
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-11
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA99457208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics