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General NPI Number Information
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NPI Number | 1891923819
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Entity Type | Organization
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Legal Business Name | LONG BEACH VA
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Dates
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Enumeration Date | 06/29/2009
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Last Update Date | 06/29/2009
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Provider Practice Location Address
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Address Line | 5901 E 7TH ST
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City | LONG BEACH
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State | CA
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Zip | 90822-5201
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Country | US
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Telephone | 562-826-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 3063 W CHAPMAN AVE APT. 7210
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City | ORANGE
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State | CA
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Zip | 92868-1738
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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 | STUDENT
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Name | JOHN HAKKYUN KIM
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Credential | D.O.
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Telephone | 909-519-6426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 286500000X
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Taxonomy Name | Military Hospital
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License Number |
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License Number State |
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