Healthcare Provider Details

I. General information

NPI: 1932746864
Provider Name (Legal Business Name): KOREAN COMMUNITY SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2019
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19742 MACARTHUR BLVD STE 245
IRVINE CA
92612-2488
US

IV. Provider business mailing address

451 W LINCOLN AVE STE 100
ANAHEIM CA
92805-2912
US

V. Phone/Fax

Practice location:
  • Phone: 714-503-6550
  • Fax: 714-409-3075
Mailing address:
  • Phone: 714-503-6550
  • Fax: 714-409-3075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: KAY AHN
Title or Position: CHIEF OPERATIONS OFFICER AND CIO
Credential:
Phone: 714-503-6550