| Hyun W Kim Dds Inc | |
|
25030 Alessandro Blvd Ste D Moreno Valley CA 92553-4383 | |
| (951) 924-0993 | |
| (951) 247-9693 |
| Full Name | Hyun W Kim Dds Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 25030 Alessandro Blvd Ste D, Moreno Valley, California |
| Authorized Official Name and Position | Hyun Woo Kim (PRESIDENT) |
| Authorized Official Contact | 9519240993 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hyun W Kim Dds Inc 25030 Alessandro Blvd Ste D Moreno Valley CA 92553-4383 Ph: (951) 924-0993 | Hyun W Kim Dds Inc 25030 Alessandro Blvd Ste D Moreno Valley CA 92553-4383 Ph: (951) 924-0993 |
| NPI Number | 1295389815 |
|---|---|
| Provider Enumeration Date | 07/31/2019 |
| Last Update Date | 05/26/2021 |
| Medicare PECOS PAC ID | 0446652697 |
|---|---|
| Medicare Enrollment ID | O20210709001275 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295389815 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Hyunwoo Kim |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1497930457 PECOS PAC ID: 9638391139 Enrollment ID: I20141118002186 |
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