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1265886543 NPI number — DONG-HEE KIM M.D.

NPI Number: 1265886543
Health Care Provider/Practitioner: DONG-HEE KIM M.D.

Information about “1265886543” NPI (DONG-HEE KIM M.D.) exists in 1265886543 in HTML format HTML  |  1265886543 in plain Text format TXT  |  1265886543 in PDF (Portable Document Format) PDF  |  1265886543 in an XML format XML  formats.

NPI Number : 1265886543 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1265886543",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KIM",
    "FirstName": "DONG-HEE",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "KIM",
    "OtherFirstName": "ANDREW",
    "OtherMiddleName": "DONGHEE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "M.D.",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "12401 WASHINGTON BLVD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WHITTIER",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90602-1006",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "716-435-4757",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "12401 WASHINGTON BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WHITTIER",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90602-1006",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "562-698-0811",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/22/2016",
    "LastUpdateDate": "07/21/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2084N0400X",
          "TaxonomyName": "Neurology Physician",
          "LicenseNumber": "305300",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2084N0400X",
          "TaxonomyName": "Neurology Physician",
          "LicenseNumber": "A172776",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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