Kim, Jae M

Kim, Jae M is an sole proprietor health care provider with primary practice located at 1433 W Merced Ave. Suite 217, West Covina CA 91790-5058. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Kim, Jae M can be contacted via phone (626) 917-1924.

Contact Information

Primary practice address
1433 W Merced Ave. Suite 217 West Covina CA 91790-5058
Phone: (626) 917-1924
Fax: (626) 337-8434
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A38835 California

Profile Details

NPI number 1689735953
LBN Legal business name Kim, Jae M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 12th, 2006
Last updated Mar 14th, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689735953 NPPES
California MEDICAID 00A388350

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