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Organization
DONG S. KIM, M.D., INC
Active
Organization
DONG S. KIM, M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONG SOO KIM M.D. (OWNER)
(951) 243-8000
Entity
Organization
Contact information
Practice address
11441 HEACOCK ST, STE. F, MORENO VALLEY, CA 92557-7907
(951) 243-8000
(951) 243-9707
Mailing address
11441 HEACOCK ST, STE. F, MORENO VALLEY, CA 92557-7907
(951) 243-8000
(951) 243-9707
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A48273
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013027465
—
CA
01
—
A48273
LICENCE
CA
Enumeration date
08/30/2006
Last updated
06/26/2015
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