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NPI Code Detail

MEDICARE: MINA KIM PA-C

MEDICARE: MINA KIM PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA

General Provider Information

NPI Number : 1023977063
Entity Type Code : Individual
Provider Name (Legal Business Name) : MINA KIM PA-C
Provider Business Mailing Address
First Line : 407 REGINA ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19116-2404
Country : US
Telephone Number : 215-992-4198
Fax Number :
Provider Business Practice Location Address
First Line : 3141 CHESTNUT ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-2816
Country : US
Telephone Number : 215-895-1600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2026
Last Update Date : 01/16/2026

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Directions to “ MINA KIM PA-C” Practice Location

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