Healthcare Provider Details

I. General information

NPI: 1205577681
Provider Name (Legal Business Name): ROBERT KIM MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2022
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BLVD # 2900A
WEST HOLLYWOOD CA
90048-1804
US

IV. Provider business mailing address

710 W 168TH ST STE 1401A
NEW YORK NY
10032-3726
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-3277
  • Fax:
Mailing address:
  • Phone: 805-220-8183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number343663
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: