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JIENSUP KIM MD A PROFESSIONAL CORPORATION NPI 1306183835


NPI Information

NPI: 1306183835
Provider Name: JIENSUP KIM MD A PROFESSIONAL CORPORATION

Doing Business As: MISSION MEDICAL

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
900 E WASHINGTON ST
SUITE 100A
COLTON, CA
ZIP 92324
Phone: (909) 370-0300
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JIENSUP KIM MD A PROFESSIONAL CORPORATION is a specialist in Colton, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. JIENSUP KIM MD A PROFESSIONAL CORPORATION NPI is 1306183835. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Mission Medical.

The provider's business location address is:

900 E WASHINGTON ST
SUITE 100A
COLTON, CA
ZIP 92324-120
Phone: (909) 370-0300
Fax: (909) 370-0303

The provider's authorized official is Jiensup Kim .
The authorized official title is President and has the following contact phone number (909) 370-0300.

The enumeration date for this NPI number is 1/3/2013 and was last updated on 2/20/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistG75806CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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