Individual
DR. KI WAN KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3601 VISTA WAY, SUITE #202, OCEANSIDE, CA 92056-4559
(760) 439-1871
Mailing address
3601 VISTA WAY, SUITE #202, OCEANSIDE, CA 92056-4559
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
63507
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/05/2011
Last updated
11/14/2014
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