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General NPI Number Information
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NPI Number | 1376703660
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Entity Type | Individual
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Provider Name | DOIL KIM DDS. MMSC.
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Gender | Male
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 07/07/2011
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Provider Practice Location Address
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Address Line | 3663 W 6TH ST STE 207
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City | LOS ANGELES
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State | CA
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Zip | 90020-3048
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Country | US
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Telephone | 213-383-2080
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Fax | 213-383-2082
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Provider Business Mailing Address
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Address Line | 3663 W 6TH ST STE 207
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City | LOS ANGELES
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State | CA
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Zip | 90020-3048
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Country | US
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Telephone | 213-383-2080
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Fax | 213-383-2082
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 9602
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 54534
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License Number State | CA
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