Dr. Ellen Wonsun Im
Pediatric Dentist
13422 Pomerado Rd Ste 201
Poway
, California 92064-3548
Dr. Ellen Wonsun Im
Pediatric Dentist
13422 Pomerado Rd Ste 201
Poway
, California 92064-3548
(858) 679-0850
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About
Features
Specialties
- Pediatric Dentist
Languages spoken
- English
Location
First Address
- Dr. Ellen Wonsun Im
- 13422 Pomerado Rd Suite 201
- Poway, CA
- Zip : 92064
- Fax : (858) 679-0850
- Phone : (858) 679-6660
Second Address
- Dr. Ellen Wonsun Im
- 13422 Pomerado Rd Ste 201
- Poway, CA
- Zip : 92064-3548
- Phone : (410) 644-4100
Reviews
FAQs
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Is Dr. Ellen Wonsun Im a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0221X | Pediatric Dentist | 63073 | CA |
National Provider Identifier
| NPI | 1023029220 |
|---|---|
| Provider Name | Dr. Ellen Wonsun Im |
| First Address | Poway, CA 92064 |
| Second Address | Poway, CA 92064-3548 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/08/2006 |
| Last Update Date | 10/05/2021 |
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.