Most Relevant Information
Provider Data
| NPI Number: | 1003405846 |
| Provider Name: | KEN SANGBOEM KIM |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/15/2021 |
| Last Updated: | 01/15/2021 |
Provider Practice Location
265 S ANITA DR
ORANGE
CA
928683355
Practice Location Phone/Fax
| Phone: | 9494396109 |
| Fax: |
Provider Mailing Location
PO BOX 17393
IRVINE
CA
926237393
Provider Mailing Phone/Fax
| Phone: | 9494396109 |
| Fax: |