Individual ProviderJongwook KimStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address1303 E. Herndon Ave., Fresno, CA 93720(559) 450-3000PECOS EnrollmentBased on the most recent information from CMS, provider Jongwook Kim does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1972390557Provider TypeIndividualFull NameKim, JongwookGenderMaleSole ProprietorNoEnumeration Date4/24/2025Last Updated12/19/2025Contact InformationPractice LocationPractice Address1303 E. Herndon Ave., Fresno, CA 93720Phone(559) 450-3000FaxUnlisted FaxMailing LocationMailing Address1303 E. Herndon Ave., Fresno, CA 93720Phone(559) 450-3000FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer