Individual
DR. EUGENE CHONGKON KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2795 W LINCOLN AVE STE L, ANAHEIM, CA 92801-6334
(714) 527-5060
(714) 527-5073
Mailing address
2795 W LINCOLN AVE STE L, ANAHEIM, CA 92801-6334
(714) 527-5060
(714) 527-5073
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
13309
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CD249A
MEDICARE GROUP PTAN
CA
Enumeration date
07/17/2007
Last updated
01/31/2024
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