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General NPI Number Information
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NPI Number | 1912086331
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Entity Type | Individual
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Provider Name | YUNGAE KRISTY KIM M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/05/2006
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Last Update Date | 11/03/2018
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Provider Practice Location Address
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Address Line | 3435 WILSHIRE BLVD STE 500
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City | LOS ANGELES
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State | CA
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Zip | 90010-1906
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Country | US
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Telephone | 213-384-3435
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Fax | 213-384-5559
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Provider Business Mailing Address
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Address Line | 3544 W OLYMPIC BLVD SUITE #202
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City | LOS ANGELES
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State | CA
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Zip | 90019-3500
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Country | US
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Telephone | 323-732-7111
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Fax | 323-732-9028
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | G51774
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License Number State | CA
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