Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
WAYNE W KIM, D.O.
Active Sole ProprietorWAYNE W KIM, D.O. is a Federally Qualified Health Center healthcare provider located in STANTON, California. NPI 1619987054 is currently active in the NPPES registry. Verify at CMS.
Federally Qualified Health Center · STANTON, CA
Registration Details
- NPI Number
- 1619987054
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 8, 2006 (20.051574302188 yrs)
- Last Updated
- Sep 14, 2022
- Licenses
-
OP00001562 (WA)OP00001562 (WA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
12362 BEACH BLVD STE 10STANTON, CA, 906803944Browse CA providers · Browse ZIP 90680
- Phone
- 7142489500
- Fax
- 7146224943
- Primary Specialty
-
Federally Qualified Health Center
261QF0400X
- Additional Specialty
- Addiction Medicine (Family Practice)
- Additional Specialty
- Community Health Center
- Additional Specialty
- Federally Qualified Health Center
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.