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General NPI Number Information
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NPI Number | 1770548091
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Entity Type | Individual
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Provider Name | MATTHEW J. KIM M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 1105 DIVISION AVE # 201
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City | TACOMA
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State | WA
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Zip | 98403-1646
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Country | US
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Telephone | 253-403-9200
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Fax | 253-403-9201
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Provider Business Mailing Address
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Address Line | PO BOX 5299 MS: 820-5-PCO
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City | TACOMA
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State | WA
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Zip | 98415-0299
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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 |
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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 | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 278794
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 48761
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | MD-21633
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License Number State | HI
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Taxonomy #4
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | MD61405475
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License Number State | WA
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