| NPI | 1255568150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YONG S KIM Doctor/Owner 770-638-1401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: GA 046142) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: GA 046142) |
| 302R00000X Health Maintenance Organization (Licence: GA 046142) | |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2009-06-18 |