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General NPI Number Information
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NPI Number | 1518814722
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Entity Type | Individual
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Provider Name | RACHAEL KIM
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Gender | Female
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 3551 PECK RD STE 101
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City | EL MONTE
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State | CA
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Zip | 91731-3547
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Country | US
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Telephone | 626-444-2002
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Fax |
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Provider Business Mailing Address
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Address Line | 1155 E DEL MAR BLVD APT 107
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City | PASADENA
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State | CA
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Zip | 91106-3427
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Country | US
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Telephone |
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 112064
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License Number State | CA
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