Individual
MS. GRACE HA EUN KANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, PHN
Contact information
Practice address
3851 ROSECRANS ST, SUITE Y15, SAN DIEGO, CA 92110-3115
(619) 692-8435
Mailing address
3851 ROSECRANS ST, SUITE Y15, SAN DIEGO, CA 92110-3115
(619) 692-8435
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
761532
CA
163WC1500X
Community Health Registered Nurse
76626
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHN 76626
CA BRN
CA
01
—
RN 761532
CA BRN
CA
Enumeration date
06/17/2015
Last updated
06/17/2015
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