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General NPI Number Information
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NPI Number | 1487707667
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Entity Type | Organization
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Legal Business Name | GRIFFIN & REED A MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 12/16/2022
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Provider Practice Location Address
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Address Line | 651 FULTON AVE
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City | SACRAMENTO
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State | CA
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Zip | 95825-4813
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Country | US
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Telephone | 916-483-2525
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Fax | 916-483-2636
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Provider Business Mailing Address
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Address Line | 651 FULTON AVE
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City | SACRAMENTO
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State | CA
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Zip | 95825-4813
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Country | US
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Telephone | 916-483-2525
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Fax |
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. KWANG S KIM
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Credential | M.D.
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Telephone | 916-483-2525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 12003T
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | A068743
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | G53735
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | A91190
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 7526T
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License Number State | CA
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