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General NPI Number Information
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NPI Number | 1821524331
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Entity Type | Individual
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Provider Name | YONWOOK JUSTIN KIM MD
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Gender | Male
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Dates
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Enumeration Date | 05/03/2017
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 3031 JAVIER RD STE 300
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City | FAIRFAX
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State | VA
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Zip | 22031-4638
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Country | US
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Telephone | 703-698-8880
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Fax |
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Provider Business Mailing Address
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Address Line | 3031 JAVIER RD STE 300
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City | FAIRFAX
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State | VA
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Zip | 22031-4638
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Country | US
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Telephone | 703-698-8880
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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 | 207WX0009X
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Taxonomy Name | Glaucoma Specialist (Ophthalmology) Physician
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License Number | 292643
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207WX0009X
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Taxonomy Name | Glaucoma Specialist (Ophthalmology) Physician
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License Number | 0101283591
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License Number State | VA
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