Provider Demographics
NPI:1982645438
Name:KANG, HUN KU (MD)
Entity Type:Individual
Prefix:DR
First Name:HUN
Middle Name:KU
Last Name:KANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-1524
Mailing Address - Country:US
Mailing Address - Phone:213-382-7022
Mailing Address - Fax:213-382-7088
Practice Address - Street 1:2900 W 8TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-1524
Practice Address - Country:US
Practice Address - Phone:213-382-7022
Practice Address - Fax:213-382-7088
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2011-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG61497207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G614970Medicaid
CAE86374Medicare UPIN