| Young Rae Kim, Dds Inc | |
|
12144 E. Carson Street Suite E Hawaiian Gardens CA 90716-1171 | |
| (562) 982-1380 | |
| (562) 982-1383 |
| Full Name | Young Rae Kim, Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 12144 E. Carson Street, Hawaiian Gardens, California |
| Authorized Official Name and Position | Young Rae Kim (PRESIDENT) |
| Authorized Official Contact | 5629821380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Young Rae Kim, Dds Inc 12144 E. Carson Street Suite E Hawaiian Gardens CA 90716-1171 Ph: (562) 982-1380 | Young Rae Kim, Dds Inc 12144 E. Carson Street Suite E Hawaiian Gardens CA 90716-1171 Ph: (562) 982-1380 |
| NPI Number | 1578808788 |
|---|---|
| Provider Enumeration Date | 11/29/2012 |
| Last Update Date | 11/29/2012 |
| Medicare PECOS PAC ID | 0244500759 |
|---|---|
| Medicare Enrollment ID | O20170717001146 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578808788 | NPI | - | NPPES |
| 1205137999 | Other | CA | DENTICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 59862 (California) | Primary |
| Provider Name | Young Rae Kim |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1205137999 PECOS PAC ID: 0749550242 Enrollment ID: I20170717001052 |
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Sahawneh Dental Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 21714 Pioneer Blvd, Hawaiian Gardens, CA 90716 Phone: 562-421-3737 | |
Hyun Chan Lee Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 12137 E Carson St, Hawaiian Gardens, CA 90716 Phone: 562-402-8060 Fax: 562-809-1552 | |
Newport Dental Hawaiian Gardens Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 21714 Pioneer Blvd, Hawaiian Gardens, CA 90716 Phone: 562-421-3737 | |
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California Dental Group Dental Clinic Medicare: Medicare Enrolled Practice Location: 12309 Carson St, Hawaiian Gardens, CA 90716 Phone: 562-403-8818 Fax: 562-403-1024 |