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General NPI Number Information
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NPI Number | 1902970783
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Entity Type | Individual
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Provider Name | YANG H KIM D.D.S
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 03/12/2010
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Provider Practice Location Address
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Address Line | 17736 SAN BERNARDINO AVE.
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City | FONTANA
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State | CA
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Zip | 92335-0000
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Country | US
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Telephone | 909-822-4363
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Fax | 909-822-4476
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Provider Business Mailing Address
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Address Line | 17736 SAN BERNARDINO AVE
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City | FONTANA
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State | CA
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Zip | 92335-6133
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Country | US
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Telephone | 909-822-4363
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Fax | 909-822-4476
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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 | 48481
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License Number State | CA
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