Healthcare Provider Details

I. General information

NPI: 1730839093
Provider Name (Legal Business Name): CLAUDIA KIM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1343 N GRAND AVE STE 100
COVINA CA
91724-4043
US

IV. Provider business mailing address

524 VAN BUREN DR
MONTEREY PARK CA
91755-4158
US

V. Phone/Fax

Practice location:
  • Phone: 626-918-2273
  • Fax:
Mailing address:
  • Phone: 626-233-5959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberA193280
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: