Kim, Choll Wan
Kim, Choll Wan is an individual health care provider with primary practice located at 6719 Alvarado Rd Ste 304 , San Diego CA 92120-5265. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine is his primary health care specialty. Kim, Choll Wan can be contacted via phone (619) 344-6918.Contact Information
Primary practice address
6719 Alvarado Rd Ste 304
San Diego CA 92120-5265
Phone: (619) 344-6918
Fax: (619) 333-6029
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | A64323 | California |
Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine | 207XS0117X | A64323 | California |
Profile Details
NPI number | 1124043765 |
---|---|
LBN Legal business name | Kim, Choll Wan |
Credentials | M.D., PH.D |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 13th, 2006 |
Last updated | Dec 12th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1124043765 | NPPES |
California | MEDICAID | 00A643230 |
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