Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CHARLES CHOL BAE KIM, MD
Active Sole ProprietorCHARLES CHOL BAE KIM, MD is a Adolescent Medicine healthcare provider located in TUSTIN, California. NPI 1225564818 is currently active in the NPPES registry. Verify at CMS.
Adolescent Medicine · TUSTIN, CA
Registration Details
- NPI Number
- 1225564818
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 3, 2017 (9.3132840687406 yrs)
- Last Updated
- Oct 13, 2021
- Licenses
-
54481 (AZ)C-129160 (CA)C129160 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
14642 NEWPORT AVE STE 105TUSTIN, CA, 927806058Browse CA providers · Browse ZIP 92780
- Phone
- 7148311112
- Fax
- 7144862309
- Primary Specialty
-
Adolescent Medicine
207QA0505X
- Additional Specialty
- Geriatric Medicine
- Additional Specialty
- Adolescent Medicine
Other Adolescent Medicine Providers in TUSTIN, CA
| Name | Credential | NPI |
|---|---|---|
| DANIEL CONSTANDSE | MD | 1275725087 |
| SOHEIL SAMVATIAN | M.D. | 1356596233 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.