Provider Demographics
NPI:1053946038
Name:KOREAN COMMUNITY SERVICES INC.
Entity type:Organization
Organization Name:KOREAN COMMUNITY SERVICES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER AND CIO
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:714-503-6550
Mailing Address - Street 1:451 W LINCOLN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-2912
Mailing Address - Country:US
Mailing Address - Phone:714-503-6550
Mailing Address - Fax:714-409-3075
Practice Address - Street 1:19742 MACARTHUR BLVD STE 250
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2488
Practice Address - Country:US
Practice Address - Phone:714-503-6550
Practice Address - Fax:714-409-3075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-10
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)