IndividualActive
Charles Chol Bae Kim, MD
NPI 1225564818 · Adult Medicine Physician · Tustin, CA
Provider details
- NPI number
- 1225564818
- Entity type
- Individual
- Primary specialty
- Adult Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 54481 (AZ)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
14642 Newport Ave Ste 105
Tustin, CA 92780-6058
Phone: (714) 831-1112
Fax: (714) 486-2309
Approximate (ZIP-level) locationGet directions
Mailing address
1200 W Mohave Rd
Parker, AZ 85344-6349
Registry dates
- Enumerated
- 2017-05-03
- Last updated
- 2021-10-13
- Certified
- 2021-10-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.