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NPI Code Detail

MEDICARE: DR. JAMES S KIM DDS

MEDICARE: DR. JAMES S KIM DDS
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
1122300000XDentist54774CA

General Provider Information

NPI Number : 1154499291
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES S KIM DDS
Provider Business Mailing Address
First Line : 9939 MAGNOLIA AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92503-3528
Country : US
Telephone Number : 562-426-7903
Fax Number :
Provider Business Practice Location Address
First Line : 9939 MAGNOLIA AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92503-3528
Country : US
Telephone Number : 562-477-6929
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2006
Last Update Date : 02/01/2016

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