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General NPI Number Information
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NPI Number | 1700812930
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Entity Type | Individual
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Provider Name | KIM RENEE GUY MD
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Gender | Female
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 03/28/2013
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Provider Practice Location Address
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Address Line | 450 BAUCHET ST DEPT OF JAIL MENTAL HEALTH
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City | LOS ANGELES
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State | CA
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Zip | 90012-2907
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Country | US
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Telephone | 213-974-9077
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Fax |
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Provider Business Mailing Address
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Address Line | 267 S SAN PEDRO ST #124
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City | LOS ANGELES
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State | CA
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Zip | 90012-3874
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Country | US
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Telephone | 310-953-5276
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 72042
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License Number State | CA
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