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General NPI Number Information
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NPI Number | 1265915029
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Entity Type | Organization
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Legal Business Name | NKGEN BIOTECH, INC.
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Dates
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Enumeration Date | 09/07/2018
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Last Update Date | 05/28/2021
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Provider Practice Location Address
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Address Line | 3001 DAIMLER ST
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City | SANTA ANA
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State | CA
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Zip | 92705-5812
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Country | US
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Telephone | 949-396-6830
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Fax | 949-396-6831
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Provider Business Mailing Address
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Address Line | 3001 DAIMLER ST
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City | SANTA ANA
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State | CA
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Zip | 92705-5812
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Country | US
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Telephone | 949-396-6830
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Fax | 949-396-6831
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. STEPHEN CHEN
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Credential |
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Telephone | 949-396-6830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | CDF00341215
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License Number State | CA
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