Charles Chol Bae Kim
Family Doctor Family Doctor - Adult Medicine Family Doctor - Geriatric Medicine
14642 Newport Ave Ste 105
Tustin
, California 92780-6058
Charles Chol Bae Kim
Family Doctor Family Doctor - Adult Medicine Family Doctor - Geriatric Medicine
14642 Newport Ave Ste 105
Tustin
, California 92780-6058
(928) 669-7380
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About
Features
Specialties
- Family Doctor
- Family Doctor - Adult Medicine
- Family Doctor - Geriatric Medicine
Languages spoken
- English
Location
First Address
- Charles Chol Bae Kim
- 1200 W Mohave Rd
- Parker, AZ
- Zip : 85344-6349
- Phone : (928) 669-7380
Second Address
- Charles Chol Bae Kim
- 14642 Newport Ave Ste 105
- Tustin, CA
- Zip : 92780-6058
- Fax : (714) 486-2309
- Phone : (714) 831-1112
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FAQs
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Is Charles Chol Bae Kim a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207Q00000X | Family Doctor | 54481 | AZ |
| Y | 207QA0505X | Family Doctor - Adult Medicine | C129160 | CA |
| N | 207QG0300X | Family Doctor - Geriatric Medicine | C-129160 | CA |
National Provider Identifier
| NPI | 1225564818 |
|---|---|
| Provider Name | Charles Chol Bae Kim |
| First Address | Parker, AZ 85344-6349 |
| Second Address | Tustin, CA 92780-6058 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/05/2017 |
| Last Update Date | 13/10/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.