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2486 W. El Camino Real Mountain View CA 94040 | |
| (650) 559-8882 | |
| (650) 559-8887 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 2486 W. El Camino Real, Mountain View, California |
| Authorized Official Name and Position | Christopher Jung Kwon Kim (PRESIDENT) |
| Authorized Official Contact | 6505598882 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2486 W. El Camino Real Mountain View CA 94040 Ph: (650) 559-8882 | 2486 W. El Camino Real Mountain View CA 94040 Ph: (650) 559-8882 |
| NPI Number | 1497183065 |
|---|---|
| Provider Enumeration Date | 10/17/2013 |
| Last Update Date | 10/17/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497183065 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 43802 (California) | Primary |
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