Provider Demographics
NPI:1780415000
Name:KANG, LINGFEI
Entity type:Individual
Prefix:
First Name:LINGFEI
Middle Name:
Last Name:KANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 E VALLEY BLVD STE 238A
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3659
Mailing Address - Country:US
Mailing Address - Phone:318-880-2828
Mailing Address - Fax:
Practice Address - Street 1:529 E VALLEY BLVD STE 238A
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3659
Practice Address - Country:US
Practice Address - Phone:318-880-2828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service