Healthcare Provider Details

I. General information

NPI: 1497626980
Provider Name (Legal Business Name): TOKIN KIM DDS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 W LAS TUNAS DR STE A
SAN GABRIEL CA
91776-1166
US

IV. Provider business mailing address

531 W LAS TUNAS DR STE A
SAN GABRIEL CA
91776-1166
US

V. Phone/Fax

Practice location:
  • Phone: 626-282-0884
  • Fax:
Mailing address:
  • Phone: 626-282-0884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TOKIN KIM
Title or Position: DENTIST
Credential: DDS
Phone: 626-282-0884