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Organization
PEDIATRIC SURGICAL ASSOCIATES OF THE EAST BAY
Active
Organization
PEDIATRIC SURGICAL ASSOCIATES OF THE EAST BAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUNGHOON KIM M.D. (MANAGING PARTNER)
(510) 428-3017
Entity
Organization
Contact information
Practice address
744 52ND ST, SUITE 4100, OAKLAND, CA 94609-1810
(510) 428-3017
(510) 428-3405
Mailing address
5528 PACHECO BLVD, SUITE A, PACHECO, CA 94553-5154
(925) 363-8170
(925) 363-8178
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0086800
—
CA
Enumeration date
04/18/2006
Last updated
05/19/2011
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