Individual
DR. JI YEONG KANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
133 ROUTE 3, DEDEDO, GU 96929-6911
(671) 645-5500
Mailing address
193 TUMON LN APT 212, TAMUNING, GU 96913-4332
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M-1829
GU
207R00000X
Internal Medicine Physician
MD-17465
HI
208M00000X
Hospitalist Physician
Primary
M-1829
GU
282N00000X
General Acute Care Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H110000
—
GU
Enumeration date
04/23/2007
Last updated
06/24/2019
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