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General NPI Number Information
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NPI Number | 1770659716
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Entity Type | Individual
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Provider Name | KUMZOO WOHN D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4165 BEVERLY BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90004-4418
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Country | US
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Telephone | 323-662-2141
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Fax |
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Provider Business Mailing Address
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Address Line | 10600 WILKINS AVE #1C
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City | LOS ANGELES
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State | CA
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Zip | 90024-6078
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Country | US
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Telephone | 310-475-5122
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 43409
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License Number State | CA
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