| Dong S. Kim, M.d., Inc | |
|
11441 Heacock St Ste. F Moreno Valley CA 92557-7907 | |
| (951) 243-8000 | |
| (951) 243-9707 |
| Full Name | Dong S. Kim, M.d., Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11441 Heacock St, Moreno Valley, California |
| Authorized Official Name and Position | Dong Soo Kim (OWNER) |
| Authorized Official Contact | 9512438000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dong S. Kim, M.d., Inc 11441 Heacock St Ste. F Moreno Valley CA 92557-7907 Ph: (951) 243-8000 | Dong S. Kim, M.d., Inc 11441 Heacock St Ste. F Moreno Valley CA 92557-7907 Ph: (951) 243-8000 |
| NPI Number | 1013027465 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 06/26/2015 |
| Medicare PECOS PAC ID | 9436208402 |
|---|---|
| Medicare Enrollment ID | O20090521000351 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013027465 | NPI | - | NPPES |
| 1013027465 | Medicaid | CA | |
| A48273 | Other | CA | LICENCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A48273 (California) | Primary |
| Provider Name | Dong Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942267992 PECOS PAC ID: 0446309413 Enrollment ID: I20090521000342 |
Riverside University Health System Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 26520 Cactus Ave, Moreno Valley, CA 92555 Phone: 951-486-4000 Fax: 951-486-4435 | |
Antonio A. Tan, Md, Professional Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12980 Frederick St, Suite D, Moreno Valley, CA 92553 Phone: 951-485-2744 Fax: 951-485-2749 | |
Planned Parenthood Pacific Southwest Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12900 Frederick St Ste C, Moreno Valley, CA 92553 Phone: 951-222-3101 | |
Joel A Pengson, Md, A Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 23180 Hemlock Ave, Moreno Valley, CA 92557 Phone: 951-243-6460 | |
John Liquete Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14114 Business Center Dr, Suite D, Moreno Valley, CA 92553 Phone: 951-697-1150 | |
Yogendra B Patel,md,inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12980 Frederick St, Suite J, Moreno Valley, CA 92553 Phone: 951-924-9300 Fax: 951-485-0240 |