Provider Demographics
NPI:1982923348
Name:KANG, KYOUNGSANG (L AC)
Entity Type:Individual
Prefix:MR
First Name:KYOUNGSANG
Middle Name:
Last Name:KANG
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1776 YGNACIO VALLEY RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3190
Mailing Address - Country:US
Mailing Address - Phone:925-478-8550
Mailing Address - Fax:925-478-4877
Practice Address - Street 1:1776 YGNACIO VALLEY RD
Practice Address - Street 2:SUITE 112
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3190
Practice Address - Country:US
Practice Address - Phone:925-478-8550
Practice Address - Fax:925-478-4877
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-25
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC 13689171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist