| |
3919 Beverly Blvd #100 Los Angeles CA 90004-3432 | |
(323) 662-1175 | |
(323) 662-7817 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 3919 Beverly Blvd, Los Angeles, California |
Authorized Official Name and Position | Il Young Kim (PRESIDENT) |
Authorized Official Contact | 3236621175 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
3919 Beverly Blvd #100 Los Angeles CA 90004-3432 Ph: (323) 662-1175 | 3919 Beverly Blvd #100 Los Angeles CA 90004-3432 Ph: (323) 662-1175 |
NPI Number | 1316130099 |
---|---|
Provider Enumeration Date | 08/24/2007 |
Last Update Date | 07/20/2010 |
Medicare PECOS PAC ID | 1254463359 |
---|---|
Medicare Enrollment ID | O20100723000780 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316130099 | NPI | - | NPPES |
A33707 | Other | CA | MEDICAID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | A33707 (California) | Primary |
Provider Name | Il Young Kim |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1447288543 PECOS PAC ID: 8325170459 Enrollment ID: I20100724000229 |
Joseph I Kang Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3755 Beverly Blvd, Ste 301, Los Angeles, CA 90004 Phone: 323-664-7777 | |
John L Sherman Md Amc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8635 W 3rd St Ste 485w, Los Angeles, CA 90048 Phone: 310-855-8081 Fax: 310-855-0438 | |
Altamed Health Services Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5425 Pomona Blvd, Los Angeles, CA 90022 Phone: 323-832-7527 Fax: 323-832-7599 | |