Nippon Clinic and Noguchi Ningen Dock LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

NIPPON CLINIC AND NOGUCHI NINGEN DOCK LLC

Practice address

3707 Convoy St
San Diego, CA 92111-3754

Phone

(858) 560-8910

Fax

(858) 560-8011

NPI assigned

Aug 9, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ildong Kim, MD

Title

Medical Director

Phone

(858) 560-8910

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326058355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 CONVOY ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113754",
            "telephone_number": "858-560-8910",
            "fax_number": "858-560-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 CONVOY ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113754",
            "telephone_number": "858-560-8910",
            "fax_number": "858-560-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIPPON CLINIC AND NOGUCHI NINGEN DOCK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "ILDONG",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "858-560-8910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Therdphong Ninklung
• Gloria C. Nino
• Porfirio Nino
• Tiffany Nino
• Scott Tsuyoshi Ninokawa, MD
• Ajay Nirula, MD
• Bree E Nishibun, DPT
• Celeste Nishijima
• Andrea D Nishimoto-Macedo
• Marin Nishimura-Kaminski

• Primary Care Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.