Provider Demographics
NPI:1730478793
Name:WANG, KATHY CHI KUAN (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHY
Middle Name:CHI KUAN
Last Name:WANG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24953 PASEO DE VALENCIA STE 6A
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-4342
Mailing Address - Country:US
Mailing Address - Phone:949-643-5030
Mailing Address - Fax:949-643-5209
Practice Address - Street 1:24953 PASEO DE VALENCIA STE 6A
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-4342
Practice Address - Country:US
Practice Address - Phone:949-643-5030
Practice Address - Fax:949-643-5209
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31924111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor