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General NPI Number Information
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NPI Number | 1285913012
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Entity Type | Organization
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Legal Business Name | SUZY KIM MD INC
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Dates
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Enumeration Date | 08/10/2011
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 2767 EAST IMPERIAL HIGHWAY ST. JUDE CENTER FOR REHABILITATION & WELLNESS
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City | BREA
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State | CA
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Zip | 92821
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Country | US
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Telephone | 714-578-8720
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Fax | 714-578-8713
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Provider Business Mailing Address
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Address Line | 5 JOURNEY STE 210
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City | ALISO VIEJO
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State | CA
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Zip | 92656-5332
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Country | US
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Telephone | 949-305-7122
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Fax | 949-305-7160
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Authorized Official
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Title or Position | PHYSICIAN
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Name | SUZY KIM
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Credential | MD
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Telephone | 650-793-6444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P0004X
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Taxonomy Name | Spinal Cord Injury Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | A86559
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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