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NPI Code Detail

MEDICARE: DR. MICHAEL HWANGSUK KIM DDS.

MEDICARE:  DR. MICHAEL HWANGSUK KIM  DDS.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223E0200XEndodontics36953CA

General Provider Information

NPI Number : 1336476373
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL HWANGSUK KIM DDS.
Provider Business Mailing Address
First Line : 12865 MAIN ST
Second Line : #201
City : GARDEN GROVE
State : CA
Zip : 92840
Country : US
Telephone Number : 714-530-7888
Fax Number : 714-530-1344
Provider Business Practice Location Address
First Line : 12865 MAIN ST
Second Line : #201
City : GARDEN GROVE
State : CA
Zip : 92840-8205
Country : US
Telephone Number : 714-530-7888
Fax Number : 714-530-1344
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2009
Last Update Date : 11/12/2009

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Directions to “ DR. MICHAEL HWANGSUK KIM DDS.” Practice Location

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