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General NPI Number Information
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NPI Number | 1770714628
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Entity Type | Individual
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Provider Name | BRYANT JUNG-KUN KIM M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 4500 S LANCASTER RD DEPT OF ANESTHESIOLOGY
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City | DALLAS
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State | TX
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Zip | 75216-7167
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Country | US
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Telephone | 714-330-7441
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Fax |
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Provider Business Mailing Address
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Address Line | 18416 RAIN DANCE TRL
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City | DALLAS
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State | TX
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Zip | 75252-7901
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Country | US
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Telephone | 714-330-7441
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A120843
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License Number State | CA
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