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Provider Information for 1255379681

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Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. RICHARD KANGAH MD

Gender: MALE

Individual NPI: 1255379681

Calendar   Last Updated:  2017-01-27
  Certification Date: 

Details

Name Value
NPI 1255379681
Enumeration Date 2006-06-04
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 3606 HIGHLAND AVE 108
HIGHLAND, CA 92346-2608
United States

Phone: 909-864-1006 | Fax: 909-864-1625
View Map External Link
Primary Practice Address 3606 HIGHLAND AVE 108
HIGHLAND, CA 92346-2608
United States

Phone: 909-864-1006 | Fax: 909-864-1625
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID CA 00A551220
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 208600000X - Surgery CA A55122