Physician Compare National (NPI:1922296623)

HEALTHCARE PROVIDER: JIN YOUNG KIM D.D.S.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1922296623
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6002132479
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150302001262
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KIM
	Individual professional last name
Provider First Name	JIN YOUNG
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK UNIVERSITY COLLEGE OF DENTISTRY
	Individual professional's medical school
Graduation Year	2003
	Individual professional's medical school graduation year
Primary Specialty	ORAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1720 E LOS ANGELES AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 224
	Group Practice or individual's line 2 address
City	SIMI VALLEY
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	930652098
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y