MEDICARE: JOY BYUNGWOOK 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	207R00000X	Internal Medicine Physician	A86479	CA

General Provider Information

NPI Number	:	1518988344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOY BYUNGWOOK KIM MD

Provider Business Mailing Address
First Line	:	908 20TH ST #A
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403
Country	:	US
Telephone Number	:	310-581-6514
Fax Number	:

Provider Business Practice Location Address
First Line	:	8700 BEVERLY BLVD
Second Line	:	2241 NT PLAZA LEVEL
City	:	LOS ANGELES
State	:	CA
Zip	:	90048
Country	:	US
Telephone Number	:	310-423-2059
Fax Number	:

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	02/14/2013

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