| Jasung Kim Psychiatrist Clinic, Apc | |
|
505 Shatto Pl Ste 204 Los Angeles CA 90020-1777 | |
| (213) 797-5953 | |
| (888) 550-3121 |
| Full Name | Jasung Kim Psychiatrist Clinic, Apc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 505 Shatto Pl Ste 204, Los Angeles, California |
| Authorized Official Name and Position | Jasung Kim (CEO) |
| Authorized Official Contact | 2137975953 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jasung Kim Psychiatrist Clinic, Apc 505 Shatto Pl Los Angeles CA 90020-1754 Ph: (213) 797-5953 | Jasung Kim Psychiatrist Clinic, Apc 505 Shatto Pl Ste 204 Los Angeles CA 90020-1777 Ph: (213) 797-5953 |
| NPI Number | 1083258073 |
|---|---|
| Provider Enumeration Date | 11/01/2019 |
| Last Update Date | 05/25/2023 |
| Certification Date | 05/25/2023 |
| Medicare PECOS PAC ID | 4587097688 |
|---|---|
| Medicare Enrollment ID | O20191203003187 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083258073 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jasung Kim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134235484 PECOS PAC ID: 9638117237 Enrollment ID: I20190802003002 |
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