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General NPI Number Information
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NPI Number | 1013125046
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Entity Type | Individual
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Provider Name | DANNY SONG KIM M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 11/30/2016
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Provider Practice Location Address
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Address Line | 121 N DIVISION ST STE 202
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City | AUBURN
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State | WA
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Zip | 98001-4931
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Country | US
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Telephone | 253-735-0843
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Fax |
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Provider Business Mailing Address
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Address Line | 315 MARTIN LUTHER KING JR WAY
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City | TACOMA
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State | WA
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Zip | 98405-4234
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 01063684A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | P5094
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD60650940
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License Number State | WA
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