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General NPI Number Information
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NPI Number | 1396982179
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Entity Type | Individual
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Provider Name | HYOUNG WOOK KIM DDS
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Gender | Male
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Dates
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Enumeration Date | 01/15/2009
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 12204 ARTESIA BLVD
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City | ARTESIA
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State | CA
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Zip | 90701-4345
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Country | US
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Telephone | 562-860-7999
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Fax | 562-568-9998
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Provider Business Mailing Address
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Address Line | 3333 S BREA CANYON RD STE 222
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City | DIAMOND BAR
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State | CA
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Zip | 91765-3785
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Country | US
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Telephone | 909-594-7999
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Fax | 909-594-9997
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 51088
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 51088
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License Number State | CA
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