| Meridian Sports Medicine & Pain Clinic | |
|
1736 W Medical Center Dr Ste B Anaheim CA 92801-1854 | |
| (714) 520-0809 | |
| (714) 520-0835 |
| Full Name | Meridian Sports Medicine & Pain Clinic |
|---|---|
| Speciality | Pain Medicine |
| Location | 1736 W Medical Center Dr Ste B, Anaheim, California |
| Authorized Official Name and Position | Chin Se Kim (PRESIDENT) |
| Authorized Official Contact | 7145200809 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meridian Sports Medicine & Pain Clinic 1736 W Medical Center Dr Ste B Anaheim CA 92801-1854 Ph: (714) 520-0809 | Meridian Sports Medicine & Pain Clinic 1736 W Medical Center Dr Ste B Anaheim CA 92801-1854 Ph: (714) 520-0809 |
| NPI Number | 1356671861 |
|---|---|
| Provider Enumeration Date | 01/05/2010 |
| Last Update Date | 02/02/2010 |
| Medicare PECOS PAC ID | 1850584376 |
|---|---|
| Medicare Enrollment ID | O20101018000062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356671861 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RS0010X | Internal Medicine - Sports Medicine | A46079 (California) | Secondary |
| 208VP0000X | Pain Medicine - Pain Medicine | A46079 (California) | Primary |
| Provider Name | Chin Se Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477564607 PECOS PAC ID: 8224072608 Enrollment ID: I20050616000376 |
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