Healthcare Provider Details

I. General information

NPI: 1336834563
Provider Name (Legal Business Name): EUNJU KIM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3551 Q ST
BAKERSFIELD CA
93301-1657
US

IV. Provider business mailing address

1100 MONDAVI WAY APT D9
BAKERSFIELD CA
93312-4349
US

V. Phone/Fax

Practice location:
  • Phone: 661-326-2000
  • Fax:
Mailing address:
  • Phone: 669-238-8964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberA209137
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: