Organization
SANTA CRUZ MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BYONG K KANG M.D. (DR.)
(703) 361-1955
Entity
Organization
Contact information
Practice address
8703 STONEWALL RD, 2B, MANASSAS, VA 20110-8325
(703) 361-1955
(703) 361-3277
Mailing address
8703 STONEWALL RD, 2B, MANASSAS, VA 20110-8325
(703) 361-1955
(703) 361-3277
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C08625
MEDICARE GROUP
VA
Enumeration date
11/28/2007
Last updated
05/15/2008
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