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General NPI Number Information
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NPI Number | 1689841207
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Entity Type | Organization
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Legal Business Name | HYO J KIM MD PC
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 2161 YGNACIO VALLEY ROAD 100
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City | WALNUT CREEK
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State | CA
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Zip | 94598-3348
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Country | US
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Telephone | 925-939-3003
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Fax |
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Provider Business Mailing Address
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Address Line | 12 STONEGATE CT
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City | ALAMO
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State | CA
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Zip | 94507-1745
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Country | US
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Telephone | 415-928-7700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HYO J KIM
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Credential | MD
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Telephone | 415-928-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | G40291
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License Number State | CA
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