Kim, Michelle Kyongah

Kim, Michelle Kyongah is an individual health care provider with primary practice located at 2245 E Colorado Blvd Ste 201, Pasadena CA 91107. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Kim, Michelle Kyongah can be contacted via phone (626) 449-3367.

Contact Information

Primary practice address
2245 E Colorado Blvd Ste 201 Pasadena CA 91107
Fax: (626) 449-3376
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 42670 California

Profile Details

NPI number 1629113857
LBN Legal business name Kim, Michelle Kyongah
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2007
Last updated Aug 26th, 2014 - about 10 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 1629113857 NPPES
California Other 42670 MEDICAL/DENTICAL

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