Individual provider · Type 1 NPI

Charles Chol Bae Kim, MD

Adult Medicine Physician · Tustin, CA

NPI number 1225564818 Active

Practice location

14642 Newport Ave Ste 105
Tustin, CA 92780-6058

Call (714) 831-1112 Map

Fax (714) 486-2309

Mailing address

1200 W Mohave Rd
Parker, AZ 85344-6349

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician 207Q00000X54481 (AZ)
Geriatric Medicine (Family Medicine) Physician 207QG0300XC-129160 (CA)
Adult Medicine Physician Primary 207QA0505XC129160 (CA)

Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.

12 other providers at this address

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About NPI 1225564818

Charles Chol Bae Kim, MD's National Provider Identifier is 1225564818, issued on May 3, 2017. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Tustin, CA. The record was last updated on Oct 13, 2021.