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General NPI Number Information
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NPI Number | 1437110327
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Entity Type | Organization
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Legal Business Name | CHARLES K. OH, MD INC.
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Dates
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Enumeration Date | 03/30/2006
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Last Update Date | 11/06/2012
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Provider Practice Location Address
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Address Line | 2552 WALNUT AVENUE 130
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City | TUSTIN
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State | CA
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Zip | 92780
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Country | US
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Telephone | 714-508-1600
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Fax | 714-665-8304
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Provider Business Mailing Address
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Address Line | 2552 WALNUT AVENUE 130
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City | TUSTIN
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State | CA
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Zip | 92780
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Country | US
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Telephone | 714-508-1600
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Fax | 714-665-8304
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. CHARLES KYUMIN OH
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Credential | MD
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Telephone | 714-508-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | A83003
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License Number State | CA
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