Provider Demographics
NPI:1982333050
Name:KS MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:KS MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KYUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-913-9927
Mailing Address - Street 1:3700 WILSHIRE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2903
Mailing Address - Country:US
Mailing Address - Phone:213-388-6168
Mailing Address - Fax:213-388-7168
Practice Address - Street 1:3160 GENEVA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1117
Practice Address - Country:US
Practice Address - Phone:213-388-6168
Practice Address - Fax:213-388-7168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center