Basic Information
| Provider Information | |||||||||
| NPI: | 1184661944 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KANG | ||||||||
| FirstName: | EUL | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7505 METRO BLVD | ||||||||
| Address2: | STE 400 | ||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554393010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6125732200 | ||||||||
| FaxNumber: | 6125732274 | ||||||||
| Practice Location | |||||||||
| Address1: | 7505 METRO BLVD | ||||||||
| Address2: | STE 400 | ||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554393010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6125732200 | ||||||||
| FaxNumber: | 6125732274 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2006 | ||||||||
| LastUpdateDate: | 08/09/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 24177 | MN | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 22843 | 01 | MN | AMERICA'S PPO | OTHER | 1605168 | 01 | MN | MEDICA | OTHER | 08586KA | 01 | MN | BLUE CROSS | OTHER | 100698 | 01 | MN | UCARE | OTHER | 300011426 | 01 | WI | RAILROAD MEDICARE WI | OTHER | 300085333 | 01 | MN | RAILROAD MEDICARE MN | OTHER | 0247007 | 01 | MN | PREFERRED ONE | OTHER | 029R3KA | 01 | MN | BLUE CROSS | OTHER | 30311500 | 05 | WI | MEDICAID | HP13647 | 01 | MN | HEALTHPARTNERS | OTHER | 77620711 | 05 | MN | MEDICAID |