MEDICARE: HOSE KIM MD INC

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	207X00000X	Orthopaedic Surgery Physician	G058070	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497748065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSE KIM MD INC

Provider Business Mailing Address
First Line	:	6712 FRIENDS AVE
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90601-4432
Country	:	US
Telephone Number	:	562-945-8873
Fax Number	:	562-945-4324

Provider Business Practice Location Address
First Line	:	6712 FRIENDS AVE
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90601-4432
Country	:	US
Telephone Number	:	562-945-8873
Fax Number	:	562-945-4324

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HOSE KIM
Credential	:	MD
Telephone Number	:	562-945-8873

Provider Enumeration Date	:	08/29/2005
Last Update Date	:	07/16/2009

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