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General NPI Number Information
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NPI Number | 1992264964
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Entity Type | Individual
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Provider Name | IRIS KIM MD
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Gender | Female
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 3816 WOODRUFF AVE STE 209
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City | LONG BEACH
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State | CA
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Zip | 90808-2145
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Country | US
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Telephone | 562-496-4749
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Fax | 562-429-3329
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Provider Business Mailing Address
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Address Line | 385 S MANCHESTER AVE UNIT 1105
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City | ORANGE
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State | CA
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Zip | 92868-3242
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Country | US
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Telephone | 808-391-4258
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 1992264964
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | A180447
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License Number State | CA
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