Provider Demographics
NPI:1043801533
Name:KOREAN COMMUNITY SERVICES INC.
Entity Type:Organization
Organization Name:KOREAN COMMUNITY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:AHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-527-6561
Mailing Address - Street 1:451 W LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-2927
Mailing Address - Country:US
Mailing Address - Phone:714-527-6561
Mailing Address - Fax:
Practice Address - Street 1:451 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-2927
Practice Address - Country:US
Practice Address - Phone:714-527-6561
Practice Address - Fax:714-527-6563
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KOREAN COMMUNITY SERVICES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)