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General NPI Number Information
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NPI Number | 1306580097
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Entity Type | Individual
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Provider Name | ALICE S KIM MD
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Gender | Female
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Dates
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Enumeration Date | 04/27/2022
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 625 S FAIR OAKS AVE STE 280
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City | PASADENA
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State | CA
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Zip | 91105-2670
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Country | US
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Telephone | 626-304-0070
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Fax |
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Provider Business Mailing Address
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Address Line | 5767 W CENTURY BLVD STE 400
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City | LOS ANGELES
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State | CA
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Zip | 90045-5631
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A198301
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License Number State | CA
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