Provider Demographics
NPI:1801529375
Name:KANG, STEVE HEEWON
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:HEEWON
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 1:128 DOLCI
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-1880
Mailing Address - Country:US
Mailing Address - Phone:949-560-0903
Mailing Address - Fax:
Practice Address - Street 1:128 DOLCI
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92602-1880
Practice Address - Country:US
Practice Address - Phone:949-560-0903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-02
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program