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General NPI Number Information
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NPI Number | 1477695393
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Entity Type | Individual
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Provider Name | YUNG TAE KIM MD
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Gender | Male
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3010 W ORANGE AVE #108
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City | ANAHEIM
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State | CA
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Zip | 92804-3169
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Country | US
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Telephone | 714-527-7731
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Fax | 714-527-7911
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Provider Business Mailing Address
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Address Line | 3010 W ORANGE AVE #108
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City | ANAHEIM
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State | CA
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Zip | 92804-3169
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Country | US
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Telephone | 714-527-7731
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Fax | 714-527-7911
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A34417
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License Number State | CA
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