Organization
FOUNTIAN VALLEY REGIONAL MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOUNGHI KIM RN (RNFA)
(714) 966-8128
Entity
Organization
Contact information
Practice address
17100 EUCLID ST, FOUNTAIN VALLEY, CA 92708-4004
(714) 966-8128
Mailing address
21136 SUNWOOD DR, WALNUT, CA 91789-3317
(909) 598-9908
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
364193
CA
Other
Enumeration date
08/25/2014
Last updated
08/25/2014
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