MEDICARE: HOWARD HYUKJIN 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	208800000X	Urology Physician	A109058	CA

General Provider Information

NPI Number	:	1386691830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOWARD HYUKJIN KIM MD

Provider Business Mailing Address
First Line	:	99 N LA CIENEGA BLVD STE M102
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2288
Country	:	US
Telephone Number	:	310-385-2992
Fax Number	:	310-385-2973

Provider Business Practice Location Address
First Line	:	99 N LA CIENEGA BLVD STE M102
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2288
Country	:	US
Telephone Number	:	310-385-2992
Fax Number	:	310-385-2973

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

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	07/24/2020

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