Individual provider · NPI-1

Byungho Kim

Technician/Technologist, Optician · San Diego, CA

NPI number1346022787
StatusActive
Last updated in NPPESOct 19, 2023

Details

NPI
1346022787
Entity type
Individual (NPI-1)
Name
Byungho Kim
Sex
Male
Sole proprietor
No
Enumeration date
Oct 19, 2023
Certification date
Oct 19, 2023
Last updated
Oct 19, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156FX1800X Technician/Technologist, Optician237277CAYes

Practice location

4633 Convoy St Ste 105
San Diego, CA 92111-2319

Phone 858-737-4818

Mailing address

4633 Convoy St Ste 105
San Diego, CA 92111-2319

Phone 858-737-4818

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