Dr Charles Chanwoong Kim, DDS is a
Dentist - General Practice based in Waterford, California. Dr Charles Chanwoong Kim is licensed to practice in California (license number 61112) and his current practice location is
12142 Yosemite Blvd, Waterford, California. He can be reached at his office (for appointments etc.) via phone at
(209) 874-2337.
NPI number for Dr Charles Chanwoong Kim is 1447523568 and his current mailing address is 12142 Yosemite Blvd, Waterford, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1447523568.
Healthcare Provider's Profile
| Full Name | Dr Charles Chanwoong Kim |
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| Gender | Male |
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| Speciality | Dentist - General Practice |
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| Location | 12142 Yosemite Blvd, Waterford, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1447523568
- Provider Enumeration Date: 02/21/2012
- Last Update Date: 03/01/2016
Medical Identifiers
Medical identifiers for Dr Charles Chanwoong Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1447523568 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | 61112 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Charles Chanwoong Kim is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Charles Chanwoong Kim, DDS
12142 Yosemite Blvd,
Waterford, CA 95386-9163
Ph: (209) 874-2337 | Dr Charles Chanwoong Kim, DDS
12142 Yosemite Blvd,
Waterford, CA 95386-9163
Ph: (209) 874-2337 |
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