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General NPI Number Information
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NPI Number | 1447269816
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Entity Type | Organization
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Legal Business Name | STEPHEN K. KIM M.D. A MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 12/08/2010
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Provider Practice Location Address
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Address Line | 900 S ATLANTIC BLVD
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City | MONTEREY PARK
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State | CA
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Zip | 91754-4716
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Country | US
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Telephone | 626-570-9000
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Fax | 626-570-5775
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Provider Business Mailing Address
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Address Line | PO BOX 60790
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City | PASADENA
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State | CA
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Zip | 91116-6790
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Country | US
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Telephone | 626-795-6596
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Fax | 626-795-8247
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHEN KYO-SUNG KIM
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Credential | M.D.
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Telephone | 909-777-7413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State | CA
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