Organization · NPI-2

Charles Kim MD INC

Family Medicine, Adult Medicine · Indio, CA

NPI number1780237313

StatusActive

Last updated in NPPESDec 5, 2024

Details

NPI: 1780237313
Entity type: Organization (NPI-2)
Legal business name: Charles Kim MD INC
Organization subpart: No
Enumeration date: Jul 23, 2019
Certification date: Dec 5, 2024
Last updated: Dec 5, 2024

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207QA0505X	Family Medicine, Adult Medicine	–	–	Yes

Practice location

39717 Camino Mistral
Indio, CA 92203-4361

Phone 497-749-9994 · Fax 442-268-1717

Mailing address

2670 N Main St Ste 100
Santa Ana, CA 92705-6639

Phone 949-527-9009 · Fax 442-268-1717

Authorized official

Hye Young Sung
Medical Billing
9495279009

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