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General NPI Number Information
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NPI Number | 1235388760
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Entity Type | Organization
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Legal Business Name | KIMS FOOT & ANKLE CLINIC INC.
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Dates
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Enumeration Date | 09/09/2008
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Last Update Date | 02/11/2010
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Provider Practice Location Address
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Address Line | 2727 W OLYMPIC BLVD #100
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City | LOS ANGELES
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State | CA
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Zip | 90006-2637
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Country | US
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Telephone | 213-380-7888
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Fax | 213-380-7884
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Provider Business Mailing Address
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Address Line | 2727 W OLYMPIC BLVD #100
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City | LOS ANGELES
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State | CA
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Zip | 90006-2637
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Country | US
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Telephone | 213-380-7888
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Fax | 213-380-7884
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL S. KIM
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Credential | D.P.M.
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Telephone | 213-380-7888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E4040
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License Number State | CA
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