Provider Demographics
NPI:1730354929
Name:KANG, JOSEPH INSUNG JR (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:INSUNG
Last Name:KANG
Suffix:JR
Gender:M
Credentials:MD, PHD
Other - Prefix:
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Mailing Address - Street 1:11234 ANDERSON ST
Mailing Address - Street 2:ROOM B121
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2804
Mailing Address - Country:US
Mailing Address - Phone:909-552-8056
Mailing Address - Fax:909-552-4829
Practice Address - Street 1:11234 ANDERSON ST
Practice Address - Street 2:ROOM B121
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2804
Practice Address - Country:US
Practice Address - Phone:909-552-8056
Practice Address - Fax:909-552-4829
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA1123752085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA112375OtherTHE MEDICAL BOARD OF CALIFORNIA