Kim, Choll Wan

Kim, Choll Wan is an individual health care provider with primary practice located at 6719 Alvarado Rd Ste 304 , San Diego CA 92120-5265. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine is his primary health care specialty. Kim, Choll Wan can be contacted via phone (619) 344-6918.

Contact Information

Primary practice address
6719 Alvarado Rd Ste 304 San Diego CA 92120-5265
Phone: (619) 344-6918
Fax: (619) 333-6029
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X A64323 California
Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine 207XS0117X A64323 California

Profile Details

NPI number 1124043765
LBN Legal business name Kim, Choll Wan
Credentials M.D., PH.D
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2006
Last updated Dec 12th, 2022 - about 4 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 1124043765 NPPES
California MEDICAID 00A643230

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