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NPI Code Detail

MEDICARE: DR. DAVID S KIM MD

MEDICARE: DR. DAVID S 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
1207Q00000XFamily Medicine PhysicianA87971CA

Other Identifiers

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

General Provider Information

NPI Number : 1528059607
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID S KIM MD
Provider Business Mailing Address
First Line : 17360 BROOKHURST ST
Second Line : ATTN: MCMF CREDENTIALING DEPARTMENT
City : FOUNTAIN VALLEY
State : CA
Zip : 92708-3720
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2110 N BELLFLOWER BLVD
Second Line :
City : LONG BEACH
State : CA
Zip : 90815-3126
Country : US
Telephone Number : 562-346-2222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2005
Last Update Date : 01/12/2016

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