Provider Demographics
NPI:1316709678
Name:KIM-ORDEN PC
Entity type:Organization
Organization Name:KIM-ORDEN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM-ORDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-274-9621
Mailing Address - Street 1:6230 IRVINE BLVD # 338
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-2103
Mailing Address - Country:US
Mailing Address - Phone:949-274-9621
Mailing Address - Fax:
Practice Address - Street 1:3751 KATELLA AVE
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3113
Practice Address - Country:US
Practice Address - Phone:562-598-1311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty