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General NPI Number Information
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NPI Number | 1639963473
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Entity Type | Organization
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Legal Business Name | WILLIAM DAE WON KIM D.D.S. A DENTAL CORPORATION
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 906 N VERMONT AVE
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City | LOS ANGELES
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State | CA
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Zip | 90029-3519
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Country | US
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Telephone | 323-522-3382
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Fax |
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Provider Business Mailing Address
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Address Line | 2485 QUEENSBERRY RD
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City | PASADENA
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State | CA
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Zip | 91104-3440
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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 | DENTIST
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Name | DR. WILLIAM DAE WON KIM
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Credential | DDS
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Telephone | 213-270-5432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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