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NPI Code Detail

MEDICARE: HYUNG-JU JOHN KIM

MEDICARE: HYUNG-JU JOHN KIM
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 : 1982777918
Entity Type Code : Individual
Provider Name (Legal Business Name) : HYUNG-JU JOHN KIM
Provider Business Mailing Address
First Line : 29 CASSIDY
Second Line :
City : IRVINE
State : CA
Zip : 92620-3537
Country : US
Telephone Number : 949-552-6061
Fax Number :
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 :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2006
Last Update Date : 06/08/2020

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Directions to “ HYUNG-JU JOHN KIM ” Practice Location

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