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General NPI Number Information
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NPI Number | 1306846167
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Entity Type | Individual
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Provider Name | YOUNG C KIM MD
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Gender | Male
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Dates
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Enumeration Date | 07/22/2005
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Last Update Date | 09/03/2009
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Provider Practice Location Address
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Address Line | 18697 BAGLEY ROAD
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City | MIDDLEBURG HEIGHTS
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State | OH
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Zip | 44130-3417
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Country | US
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Telephone | 440-816-8770
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Fax | 440-816-8806
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Provider Business Mailing Address
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Address Line | 5655 HUDSON DRIVE SUITE 210
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City | HUDSON
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State | OH
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Zip | 44236-4451
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Country | US
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Telephone | 330-655-3800
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Fax | 330-655-3828
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 35045848
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 35.045848
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License Number State | OH
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