Mr. Kwang Jin Kim
Dental Public Health
3300 W Rosecrans Ave Suite 105
Hawthorne
, California 90250-8218
Mr. Kwang Jin Kim
Dental Public Health
3300 W Rosecrans Ave Suite 105
Hawthorne
, California 90250-8218
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About
Features
Specialties
- Dental Public Health
Languages spoken
- English
Location
First Address
- Mr. Kwang Jin Kim
- 2220 Smokewood Ave
- Fullerton, CA
- Zip : 92831-1107
- Phone :
Second Address
- Mr. Kwang Jin Kim
- 3300 W Rosecrans Ave Suite 105
- Hawthorne, CA
- Zip : 90250-8218
- Fax : (310) 679-3932
- Phone : (310) 679-3300
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Is Mr. Kwang Jin Kim a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223D0001X | Dental Public Health | 31300 | CA |
National Provider Identifier
| NPI | 1578611356 |
|---|---|
| Provider Name | Mr. Kwang Jin Kim |
| First Address | Fullerton, CA 92831-1107 |
| Second Address | Hawthorne, CA 90250-8218 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/01/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| B-31300-02 | MEDICAL PROVIDER NUMBER (01) | CA |
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.