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General NPI Number Information
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NPI Number | 1013237437
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Entity Type | Organization
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Legal Business Name | JAMES Y KIM D.D.S INC
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Dates
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Enumeration Date | 06/08/2010
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Last Update Date | 06/08/2010
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Provider Practice Location Address
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Address Line | 15890 GALE AVE
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City | HACIENDA HEIGHTS
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State | CA
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Zip | 91745-1601
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Country | US
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Telephone | 626-333-0111
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Fax | 626-333-2400
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Provider Business Mailing Address
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Address Line | 15890 GALE AVE
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City | HACIENDA HEIGHTS
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State | CA
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Zip | 91745-1601
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Country | US
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Telephone | 626-333-0111
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Fax | 626-333-2400
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Authorized Official
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Title or Position | DENTIST
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Name | JAMES YOUNG KIM
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Credential | D.D.S.
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Telephone | 626-333-0111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 34506
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License Number State | CA
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