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NPI Code Detail

MEDICARE: CHRIS K.H KIM D.D.S.

MEDICARE:   CHRIS K.H KIM  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry42669CA

General Provider Information

NPI Number : 1043438021
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRIS K.H KIM D.D.S.
Provider Business Mailing Address
First Line : 1391 S DIAMOND BAR BLVD
Second Line :
City : DIAMOND BAR
State : CA
Zip : 91765-2208
Country : US
Telephone Number : 909-860-1222
Fax Number : 909-860-0134
Provider Business Practice Location Address
First Line : 1391 S DIAMOND BAR BLVD
Second Line :
City : DIAMOND BAR
State : CA
Zip : 91765-2208
Country : US
Telephone Number : 909-860-1222
Fax Number : 909-860-0134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2007
Last Update Date : 07/08/2007

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Directions to “ CHRIS K.H KIM D.D.S.” Practice Location

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