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General NPI Number Information
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NPI Number | 1366620189
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Entity Type | Organization
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Legal Business Name | INTERNATIONAL COMMUNITY HEALTHCARE RESOURCE, INC
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Dates
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Enumeration Date | 02/04/2008
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Last Update Date | 02/04/2008
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Provider Practice Location Address
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Address Line | 1533 CALIFORNIA CIR #100
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City | MILPITAS
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State | CA
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Zip | 95035-8101
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Country | US
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Telephone | 408-719-1004
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Fax | 408-719-1094
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Provider Business Mailing Address
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Address Line | 1533 CALIFORNIA CIR #100
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City | MILPITAS
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State | CA
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Zip | 95035-8101
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Country | US
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Telephone | 408-719-1004
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Fax | 408-719-1094
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. TAE KYUNG KIM
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Credential | D.C.
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Telephone | 408-719-1004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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