Healthcare Provider Details

I. General information

NPI: 1831732270
Provider Name (Legal Business Name): CANDICE KIM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2019
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25395 HANCOCK AVE STE 230
MURRIETA CA
92562-9054
US

IV. Provider business mailing address

25395 HANCOCK AVE STE 230
MURRIETA CA
92562-9054
US

V. Phone/Fax

Practice location:
  • Phone: 951-677-6670
  • Fax: 951-677-6676
Mailing address:
  • Phone: 951-677-6670
  • Fax: 951-677-6676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: CANDICE JINHEE KIM
Title or Position: PHYSICIAN/PRESIDENT
Credential: MD
Phone: 510-520-5316