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Individual
ALEXANDER KISAM JHANG
Active
Individual
ALEXANDER KISAM JHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
42664
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013553
DELTA CARE PMI
CA
01
—
42664
CALIFORNIA LICENSE
CA
01
—
B42664-02
HEALTHY FAMILY PROGRAM
CA
01
—
G93605-01
DENTI-CAL PROVIDER NUMBER
CA
Enumeration date
03/08/2007
Last updated
09/09/2015
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