| Charles Kim Md Inc | |
|
14642 Newport Ave Ste 105 Tustin CA 92780-6058 | |
| (951) 801-5566 | |
| (714) 486-2309 |
| Full Name | Charles Kim Md Inc |
|---|---|
| Speciality | Family Medicine - Geriatric Medicine |
| Location | 14642 Newport Ave Ste 105, Tustin, California |
| Authorized Official Name and Position | Linda Mack (ADMINISTRATOR/DELEGATED OFFICIAL) |
| Authorized Official Contact | 9518015566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Kim Md Inc 14642 Newport Ave Ste 105 Tustin CA 92780-6058 Ph: (951) 801-5566 | Charles Kim Md Inc 14642 Newport Ave Ste 105 Tustin CA 92780-6058 Ph: (951) 801-5566 |
| NPI Number | 1063050193 |
|---|---|
| Provider Enumeration Date | 12/19/2019 |
| Last Update Date | 12/19/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063050193 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
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