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NPI Code Detail

MEDICARE: HYUNG-JU JOHN KIM DDS INC

MEDICARE: HYUNG-JU JOHN KIM DDS INC
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
1122300000XDentist49122CA

General Provider Information

NPI Number : 1619101540
Entity Type Code : Organization
Provider Name (Legal Business Name) : HYUNG-JU JOHN KIM DDS INC
Provider Business Mailing Address
First Line : 2805 S SAN PEDRO ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90011-2023
Country : US
Telephone Number : 323-846-8443
Fax Number : 323-846-8448
Provider Business Practice Location Address
First Line : 2805 S SAN PEDRO ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90011-2023
Country : US
Telephone Number : 323-846-8443
Fax Number : 323-846-8448
Authorized Official
Title or Position : CEO
Name : DR. HYUNG-JU JOHN KIM
Credential : DDS
Telephone Number : 323-846-8443
Provider Enumeration Date : 05/06/2009
Last Update Date : 05/06/2009

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Directions to “HYUNG-JU JOHN KIM DDS INC ” Practice Location

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