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General NPI Number Information
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NPI Number | 1982178828
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Entity Type | Organization
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Legal Business Name | HYUNG-JU JOHN KIM DDS INC
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Dates
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Enumeration Date | 01/14/2019
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Last Update Date | 01/14/2019
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Provider Practice Location Address
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Address Line | 6515 ATLANTIC AVE
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City | BELL
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State | CA
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Zip | 90201-2521
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Country | US
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Telephone | 323-846-8642
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Fax |
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Provider Business Mailing Address
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Address Line | 6515 ATLANTIC AVE
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City | BELL
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State | CA
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Zip | 90201-2521
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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 | MANAGER
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Name | SANDRA RANGEL
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Credential |
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Telephone | 310-988-0574
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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 |
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License Number State |
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