Organization
KINCAIDS NUTRITION CENTER
Active
Organization
KINCAIDS NUTRITION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YONG SUNG KIM (PRESIDENT)
(323) 726-1947
Entity
Organization
Contact information
Practice address
711 NEWMARK MALL, MONTEBELLO, CA 90640-4752
(323) 726-1947
(323) 726-1948
Mailing address
711 NEWMARK MALL, MONTEBELLO, CA 90640-4752
(323) 726-1947
(323) 726-1948
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
12375
CA
Other
Enumeration date
03/11/2009
Last updated
03/11/2009
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