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General NPI Number Information
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NPI Number | 1063483667
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Entity Type | Individual
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Provider Name | KIM KIA YU MD
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Gender | Female
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 19742 MACARTHUR BLVD STE 250
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City | IRVINE
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State | CA
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Zip | 92612-2488
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Country | US
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Telephone | 714-503-6550
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Fax | 714-309-4075
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Provider Business Mailing Address
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Address Line | 451 W LINCOLN AVE STE 100
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City | ANAHEIM
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State | CA
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Zip | 92805-2912
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Country | US
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Telephone | 714-503-6550
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Fax | 714-409-3075
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301070014
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License Number State | MI
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