Healthcare Provider Details

I. General information

NPI: 1114145497
Provider Name (Legal Business Name): THE SPRING HIGHLAND FIELDS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7811 COMMONWEALTH AVE
BUENA PARK CA
90621-2422
US

IV. Provider business mailing address

7811 COMMONWEALTH AVE
BUENA PARK CA
90621-2422
US

V. Phone/Fax

Practice location:
  • Phone: 714-522-4960
  • Fax: 714-522-4961
Mailing address:
  • Phone: 714-522-4960
  • Fax: 714-522-4961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. JUN HEE KIM
Title or Position: ADMINISTRATOR
Credential: PH.D.
Phone: 714-522-4960