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General NPI Number Information
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NPI Number | 1891502001
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Entity Type | Individual
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Provider Name | CHANGKYU KIM
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Gender | Male
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Dates
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Enumeration Date | 12/12/2024
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 9730 WILSHIRE BLVD STE 207
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-2004
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Country | US
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Telephone | 213-434-6756
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Fax | 323-967-9000
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Provider Business Mailing Address
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Address Line | 3185 WILSHIRE BLVD UNIT 783
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City | LOS ANGELES
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State | CA
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Zip | 90010-1253
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Country | US
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Telephone | 213-434-6756
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Fax | 323-967-9000
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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 | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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