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General NPI Number Information
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NPI Number | 1063652386
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Entity Type | Individual
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Provider Name | BENJAMIN KIM M.D., M.PHIL.
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Gender | Male
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Dates
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Enumeration Date | 02/26/2009
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Last Update Date | 03/01/2017
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Provider Practice Location Address
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Address Line | 725 WELCH RD
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City | PALO ALTO
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State | CA
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Zip | 94304-1601
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Country | US
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Telephone | 650-497-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 1 DNA WAY MS 444B
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080-4918
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Country | US
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Telephone | 650-866-2058
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | A94562
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License Number State | CA
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