Individual
DONGWHAN DUSTIN IM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
13522 NEWPORT AVE, TUSTIN, CA 92780-3707
(714) 987-1121
Mailing address
PO BOX 5532, IRVINE, CA 92616-5532
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
CA
Other
Enumeration date
07/12/2022
Last updated
07/09/2025
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