Organization
WESTERN PATHOLOGY MEDICAL ASSOC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUN KIM MD (PRESIDENT)
(714) 953-3381
Entity
Organization
Contact information
Practice address
1001 N TUSTIN AVE, SANTA ANA, CA 92705-3502
(714) 953-3381
(714) 953-3541
Mailing address
5856 CORPORATE AVE, SUITE 200, CYPRESS, CA 90630-4754
(714) 236-4000
(714) 236-4006
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0085940
—
CA
05
—
GR0085941
—
CA
01
—
ZZZ01419Z
BLUE SHIELD
CA
01
—
ZZZ59624Z
BLUE SHIELD
CA
Enumeration date
10/21/2006
Last updated
06/19/2015
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