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General NPI Number Information
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NPI Number | 1861527897
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Entity Type | Individual
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Provider Name | JOONG GAP KIM M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 9540 ARTESIA BLVD STE 2
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City | BELLFLOWER
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State | CA
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Zip | 90706-6598
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Country | US
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Telephone | 562-920-7602
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Fax | 562-920-2533
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Provider Business Mailing Address
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Address Line | 9540 ARTESIA BLVD STE 2
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City | BELLFLOWER
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State | CA
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Zip | 90706-6598
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Country | US
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Telephone | 562-920-7602
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Fax | 562-920-2533
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | A39214
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License Number State | CA
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