Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT10983 | CA |
NPI | 1003898537 |
---|---|
Provider Name | Danny Kang |
First Address | La Palma, CA 90623-2576 |
Second Address | Garden Grove, CA 92844-1639 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 18/03/2017 |