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General NPI Number Information
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NPI Number | 1730501263
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Entity Type | Organization
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Legal Business Name | PAUL KIM DMD,INC
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Dates
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Enumeration Date | 01/17/2014
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Last Update Date | 01/17/2014
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Provider Practice Location Address
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Address Line | 11900 SOUTH ST STE 122
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City | CERRITOS
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State | CA
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Zip | 90703-6800
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Country | US
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Telephone | 562-809-6177
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Fax | 562-809-7659
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Provider Business Mailing Address
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Address Line | 11900 SOUTH ST STE 122
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City | CERRITOS
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State | CA
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Zip | 90703-6800
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Country | US
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Telephone | 562-809-6177
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Fax | 562-809-7659
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL KIM
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Credential | DMD
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Telephone | 562-809-6177
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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 | 40253
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License Number State | CA
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