| North Regional Infectious Diseases Pa | |
|
1730 Lake Forest Dr Rockwall TX 75087-3342 | |
| (972) 955-0145 | |
| (214) 660-2525 |
| Full Name | North Regional Infectious Diseases Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1730 Lake Forest Dr, Rockwall, Texas |
| Authorized Official Name and Position | David Seong Cheol Kim (PRESIDENT/OWNER) |
| Authorized Official Contact | 9729550145 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Regional Infectious Diseases Pa Po Box 851978 Mesquite TX 75185-1978 Ph: (972) 955-0145 | North Regional Infectious Diseases Pa 1730 Lake Forest Dr Rockwall TX 75087-3342 Ph: (972) 955-0145 |
| NPI Number | 1306233291 |
|---|---|
| Provider Enumeration Date | 04/20/2015 |
| Last Update Date | 04/20/2015 |
| Medicare PECOS PAC ID | 0941529119 |
|---|---|
| Medicare Enrollment ID | O20150511000693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306233291 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | K9585 (Texas) | Primary |
| Provider Name | David S Kim |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1487737714 PECOS PAC ID: 3476518978 Enrollment ID: I20041123001281 |
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