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NPI Code Detail

MEDICARE: DR. CHRIS Y KIM M.D.

MEDICARE: DR. CHRIS Y KIM M.D.
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
1207RC0000XCardiovascular Disease Physician04-43106KS
2207RC0000XCardiovascular Disease Physician43944CO

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 : 1649214115
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRIS Y KIM M.D.
Provider Business Mailing Address
First Line : 2222 N NEVADA AVE STE 4007
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-6863
Country : US
Telephone Number : 719-776-8500
Fax Number : 719-776-4595
Provider Business Practice Location Address
First Line : 2222 N NEVADA AVE STE 4007
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-6863
Country : US
Telephone Number : 719-776-8500
Fax Number : 719-776-4595
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 02/09/2021

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