Individual ProviderSophia Kyein KangPharmacistPharmacy Service ProvidersPractice Address101 Bodin Cir, Travis Afb, CA 94535-1809(707) 423-7119(707) 423-7657PECOS EnrollmentBased on the most recent information from CMS, provider Sophia Kyein Kang does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:10 AM.Profile DetailsProvider ID1033580303Provider TypeIndividualFull NameKang, Sophia KyeinGenderFemaleSole ProprietorNoEnumeration Date10/13/2015Last Updated3/28/2023Contact InformationPractice LocationPractice Address101 Bodin Cir, Travis Afb, CA 94535-1809Phone(707) 423-7119FaxUnlisted FaxMailing LocationMailing Address101 Bodin Cir, Travis Afb, CA 94535-1809Phone(707) 423-7657Fax(707) 423-5346Provider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicense060365New YorkProvider IdentifiersIDDescriptionIssuerID060365DescriptionOtherIssuerNYSNew York