Healthcare Provider Details

I. General information

NPI: 1407829385
Provider Name (Legal Business Name): WILLIAM KIM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: WILLIAM W. KIM M.D.

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7455 W WASHINGTON AVE STE 480
LAS VEGAS NV
89128-4338
US

IV. Provider business mailing address

5980 S RAINBOW BLVD STE 100
LAS VEGAS NV
89118-4202
US

V. Phone/Fax

Practice location:
  • Phone: 702-320-8111
  • Fax: 702-320-8112
Mailing address:
  • Phone: 702-765-7246
  • Fax: 702-765-7227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberNV6486
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberNV6486
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberNV6486
License Number StateNV
# 4
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberNV6486
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: