Iksoo Kang, MD | |
101 E Valencia Mesa Dr, Em Dept, Fullerton, CA 92835-3809 | |
(714) 992-3965 | |
Not Available |
Full Name | Iksoo Kang |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 101 E Valencia Mesa Dr, Fullerton, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1093758393 | NPI | - | NPPES |
00A707340 | Medicaid | CA | |
00A707340 | Other | CA | BLUE SHIELD |
A70734 | Other | CA | ANTHEM BLUE CROSS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | A70734 (California) | Primary |
Entity Name | St Jude Emergency Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720190804 PECOS PAC ID: 8224923479 Enrollment ID: O20040217001064 |
Mailing Address | Practice Location Address |
---|---|
Iksoo Kang, MD 4401 W Memorial Rd, Suite 121, Oklahoma City, OK 73134-1785 Ph: (405) 751-4664 | Iksoo Kang, MD 101 E Valencia Mesa Dr, Em Dept, Fullerton, CA 92835-3809 Ph: (714) 992-3965 |
Erwin K Song, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 101 E Valencia Mesa Dr, Em Dept, Fullerton, CA 92835 Phone: 714-992-3965 | |
Matthew Mckay, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 101 E Valencia Mesa Dr, Em Dept, Fullerton, CA 92835 Phone: 714-992-3965 | |
Timothy G Greco, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 101 E Valencia Mesa Dr, Em Dept, Fullerton, CA 92835 Phone: 714-992-3965 | |
Karl Feng, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 101 E Valencia Mesa Dr, Em Dept, Fullerton, CA 92835 Phone: 714-992-3965 | |
Andy D Tran, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2141 N Harbor Blvd Ste 25000, Fullerton, CA 92835 Phone: 714-626-8669 Fax: 714-626-8692 | |
Dr. Jeremy Joseph Lins, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 101 E Valencia Mesa Dr, Fullerton, CA 92835 Phone: 714-871-3280 |