Provider Demographics
NPI:1669531463
Name:KANG, JOHN CHOONGWHA (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHOONGWHA
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 1:1901 S HOGAN CT
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-2070
Mailing Address - Country:US
Mailing Address - Phone:310-431-7902
Mailing Address - Fax:
Practice Address - Street 1:1300 N VERMONT AVE
Practice Address - Street 2:HEALTH CARE CONSULTATION CTR; DOCTORS TOWER 1ST FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6005
Practice Address - Country:US
Practice Address - Phone:323-913-4350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA840862086X0206X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology