Provider Demographics
NPI:1831242502
Name:KANG, ELIZABETH MARIA (LAC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARIA
Last Name:KANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22910 CRENSHAW BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3060
Mailing Address - Country:US
Mailing Address - Phone:310-530-7780
Mailing Address - Fax:310-530-7783
Practice Address - Street 1:22910 CRENSHAW BLVD STE C
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3060
Practice Address - Country:US
Practice Address - Phone:310-530-7780
Practice Address - Fax:310-530-7783
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC9965171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist