Provider Demographics
NPI:1669159190
Name:KANG, CHLOE INHYE (OD)
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:INHYE
Last Name:KANG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20398 BLAUER DR
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-4307
Mailing Address - Country:US
Mailing Address - Phone:408-777-6350
Mailing Address - Fax:408-777-6354
Practice Address - Street 1:20398 BLAUER DR
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-4307
Practice Address - Country:US
Practice Address - Phone:408-777-6350
Practice Address - Fax:408-777-6354
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35517152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty