Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dongwhan Dustin Im, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1174257414

Dongwhan Dustin Im, PHYSICIANASSISTANT is a Physician Assistant in Fullerton, California. Practices as a sole proprietor and works from 2 locations. Licensed in California.

Licensed in
CA
In the registry since
2022

Practice location Address checks out

1950 Sunny Crest Dr Ste 2600
Fullerton, CA 92835-3644
Phone: (714) 446-5590
Fax: (714) 446-5592
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 13522 Newport Ave, Tustin, CA 92780-3707 — (714) 987-1121

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (CA)

Record details

NPI number1174257414
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedJuly 12, 2022
Last updated in NPPESJune 18, 2026
Certification dateJune 18, 2026

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