MEDICARE: DAVID EDWIN KIM MD

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	208200000X	Plastic Surgery Physician	G85117	CA

General Provider Information

NPI Number	:	1366538209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID EDWIN KIM MD

Provider Business Mailing Address
First Line	:	436 N BEDFORD DR STE 305
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-4320
Country	:	US
Telephone Number	:	310-271-6996
Fax Number	:	310-271-7241

Provider Business Practice Location Address
First Line	:	436 N BEDFORD DR STE 305
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-4320
Country	:	US
Telephone Number	:	310-271-6996
Fax Number	:	310-271-7241

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	05/22/2014

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