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NPI Code Detail

MEDICARE: TOKIN KIM DDS

MEDICARE:   TOKIN  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
11223G0001XGeneral Practice Dentistry105092CA

General Provider Information

NPI Number : 1760080998
Entity Type Code : Individual
Provider Name (Legal Business Name) : TOKIN KIM DDS
Provider Business Mailing Address
First Line : 2141 ELDERWAY DR
Second Line :
City : HACIENDA HEIGHTS
State : CA
Zip : 91745-4935
Country : US
Telephone Number : 909-255-2908
Fax Number :
Provider Business Practice Location Address
First Line : 531 W LAS TUNAS DR STE A
Second Line :
City : SAN GABRIEL
State : CA
Zip : 91776-1166
Country : US
Telephone Number : 714-323-8007
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2020
Last Update Date : 10/09/2020

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Directions to “ TOKIN KIM DDS” Practice Location

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