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General NPI Number Information
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NPI Number | 1760960298
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Entity Type | Organization
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Legal Business Name | YURI M. KIM, D.O., P.C.
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Dates
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Enumeration Date | 08/06/2018
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Last Update Date | 04/26/2020
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Provider Practice Location Address
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Address Line | 10 CONGRESS ST STE 350
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City | PASADENA
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State | CA
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Zip | 91105-3020
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Country | US
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Telephone | 626-509-9449
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Fax | 309-305-3542
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Provider Business Mailing Address
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Address Line | 235 S SAN PEDRO ST APT 620
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City | LOS ANGELES
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State | CA
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Zip | 90012-3584
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DERMATOLOGIST
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Name | DR. YURI KIM
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Credential | DO
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Telephone | 562-228-3552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 20A15354
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License Number State | CA
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