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Individual

MR. KI SANG YI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1703 TERMINO AVE, SUITE #103, LONG BEACH, CA 90804-2124
(562) 597-5100
(562) 597-5165
Mailing address
1703 TERMINO AVE, SUITE #103, LONG BEACH, CA 90804-2124
(562) 597-5100
(562) 597-5165

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E4250
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000E42500
CA
01
E4250A
PALMETTO GBA
CA
Enumeration date
08/11/2006
Last updated
03/07/2023
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