Healthcare Provider Details

I. General information

NPI: 1447829031
Provider Name (Legal Business Name): MINHEE KIM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2021
Last Update Date: 06/07/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 W OLYMPIC BLVD STE 313
LOS ANGELES CA
90006-2699
US

IV. Provider business mailing address

2727 W OLYMPIC BLVD STE 313
LOS ANGELES CA
90006-2699
US

V. Phone/Fax

Practice location:
  • Phone: 213-322-2057
  • Fax: 213-322-2052
Mailing address:
  • Phone: 213-322-2057
  • Fax: 213-322-2052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA196485
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: