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6105 Rosemead Blvd Ste A Pico Rivera CA 90660-3223 | |
| (562) 949-9616 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 6105 Rosemead Blvd Ste A, Pico Rivera, California |
| Authorized Official Name and Position | Michele Lee Kim (CEO) |
| Authorized Official Contact | 5629499616 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6105 Rosemead Blvd Ste A Pico Rivera CA 90660-3223 Ph: (562) 949-9616 | 6105 Rosemead Blvd Ste A Pico Rivera CA 90660-3223 Ph: (562) 949-9616 |
| NPI Number | 1881891125 |
|---|---|
| Provider Enumeration Date | 06/29/2007 |
| Last Update Date | 06/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881891125 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 42672 (California) | Primary |
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