Healthcare Provider Details

I. General information

NPI: 1588642581
Provider Name (Legal Business Name): DANIEL K KIM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6950 W DESERT INN #110
LAS VEGAS NV
89117
US

IV. Provider business mailing address

6950 W DESERT INN #110
LAS VEGAS NV
89117
US

V. Phone/Fax

Practice location:
  • Phone: 702-259-5500
  • Fax: 702-259-5554
Mailing address:
  • Phone: 702-259-5500
  • Fax: 702-259-5554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number5693
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number5693
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: