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General NPI Number Information
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NPI Number | 1861415820
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Entity Type | Individual
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Provider Name | CECILIA SUE-YOUN KIM MD
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Gender | Female
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11301 WILSHIRE BLVD MAIL CODE 111H
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City | LOS ANGELES
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State | CA
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Zip | 90073-1003
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Country | US
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Telephone | 310-268-3622
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Fax | 310-268-4508
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Provider Business Mailing Address
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Address Line | 8203 HANNUM AVE
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City | CULVER CITY
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State | CA
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Zip | 90230-6171
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Country | US
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Telephone | 310-613-4945
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Fax | 310-390-4945
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | G74909
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License Number State | CA
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