Organization
PEDIATRIC SURGICAL ASSOCIATES OF THE EAST BAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUNGHOON KIM M.D. (MANAGING PARTNER)
(510) 428-3017
Entity
Organization
Contact information
Practice address
744 52ND ST, SUITE 4100, OAKLAND, CA 94609-1810
(510) 428-3017
(510) 428-3405
Mailing address
5528 PACHECO BLVD, SUITE A, PACHECO, CA 94553-5154
(925) 363-8170
(925) 363-8178
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0086800
—
CA
Enumeration date
04/18/2006
Last updated
05/19/2011
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