Healthcare Provider Details

I. General information

NPI: 1669148797
Provider Name (Legal Business Name): RHMG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2021
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4661 WILSHIRE BLVD. # 105
LOS ANGELES CA
90010
US

IV. Provider business mailing address

1601 N SEPULVEDA BLVD # 103
MANHATTAN BEACH CA
90266-5111
US

V. Phone/Fax

Practice location:
  • Phone: 703-326-2029
  • Fax:
Mailing address:
  • Phone: 703-326-2029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: EUGENE L. KIM
Title or Position: CEO
Credential: M.D.
Phone: 703-326-2029