Provider Demographics
NPI:1801422332
Name:KANG, SEO YOUN (RPH)
Entity type:Individual
Prefix:
First Name:SEO
Middle Name:YOUN
Last Name:KANG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 MONARCH LN APT J
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-2334
Mailing Address - Country:US
Mailing Address - Phone:831-277-8292
Mailing Address - Fax:
Practice Address - Street 1:416 ALVARADO ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2711
Practice Address - Country:US
Practice Address - Phone:831-644-9057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81383183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist