Gin, Jeffrey Kim-Wayne

Gin, Jeffrey Kim-Wayne is an individual health care provider with primary practice located at 218 W Badillo St , Covina CA 91723-1906. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gin, Jeffrey Kim-Wayne can be contacted via phone (626) 332-6234.

Contact Information

Primary practice address
218 W Badillo St Covina CA 91723-1906
Phone: (626) 332-6234
Fax: (626) 331-1264
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35797 Arizona
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A101609 California

Profile Details

NPI number 1225140759
LBN Legal business name Gin, Jeffrey Kim-Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Feb 21st, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225140759 NPPES
California MEDICAID GR0070010

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