Organization
JONG G KIM M.D. A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONG G. KIM M.D. (PHYSICIAN)
(909) 860-0606
Entity
Organization
Contact information
Practice address
414 S PROSPECTORS RD, SUITE B, DIAMOND BAR, CA 91765-1615
(909) 860-0606
(909) 860-6161
Mailing address
414 S PROSPECTORS RD, SUITE B, DIAMOND BAR, CA 91765-1615
(909) 860-0606
(909) 860-6161
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A32816
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6169716
—
CA
Enumeration date
12/13/2006
Last updated
12/21/2017
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