Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 26538 | NE |
Y | 207YP0228X | Pediatric Otolaryngology | G56927 | CA |
N | 2086S0120X | Pediatric Surgery | 35083148 | OH |
NPI | 1124073309 |
---|---|
Provider Name | Dr. Dong Kyoo Richard Kang |
First Address | Palo Alto, CA 94304-1601 |
Second Address | Palo Alto, CA 94304-1601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 17/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E71033 | (02) |