MEDICARE: DR. DAVID SEIL KIM MD, MS, MBA

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
1	207V00000X	Obstetrics & Gynecology Physician	C53881	CA

General Provider Information

NPI Number	:	1184608259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID SEIL KIM MD, MS, MBA

Provider Business Mailing Address
First Line	:	PO BOX 512717
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90051-0717
Country	:	US
Telephone Number	:	310-423-2914
Fax Number	:	310-423-0313

Provider Business Practice Location Address
First Line	:	444 S SAN VICENTE BLVD
Second Line	:	STE 1003
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-4165
Country	:	US
Telephone Number	:	310-423-9268
Fax Number	:	310-423-1272

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2005
Last Update Date	:	09/20/2013

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