Kim, Rick Tae

Kim, Rick Tae is an individual health care provider with primary practice located at 21012 Norwalk Blvd , Lakewood CA 90715-1503. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Kim, Rick Tae can be contacted via phone (562) 860-8828.

Contact Information

Primary practice address
21012 Norwalk Blvd Lakewood CA 90715-1503
Phone: (562) 860-8828
Fax: (562) 869-0444
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 48622 California

Profile Details

NPI number 1124156427
LBN Legal business name Kim, Rick Tae
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2007
Last updated Jul 8th, 2007 - about 18 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 1124156427 NPPES
California Other G92417-01 DENTI-CAL
California Other G92789-01 DENTI-CAL

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