MEDICARE: YOUNG KIM MD,PHD

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	207RC0001X	Clinical Cardiac Electrophysiology Physician	2020004739	MO
2	207RC0001X	Clinical Cardiac Electrophysiology Physician	72768	AZ
3	207R00000X	Internal Medicine Physician	A127211	CA
4	207RC0001X	Clinical Cardiac Electrophysiology Physician	A127211	CA
5	207RC0000X	Cardiovascular Disease Physician	A127211	CA

General Provider Information

NPI Number	:	1700207941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOUNG KIM MD,PHD

Provider Business Mailing Address
First Line	:	20126 STANTON AVE STE 100
Second Line	:
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94546-5270
Country	:	US
Telephone Number	:	510-537-3556
Fax Number	:

Provider Business Practice Location Address
First Line	:	20126 STANTON AVE STE 100
Second Line	:
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94546-5270
Country	:	US
Telephone Number	:	510-537-3556
Fax Number	:

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

Provider Enumeration Date	:	12/13/2013
Last Update Date	:	12/23/2025

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Directions to “ YOUNG KIM MD,PHD” Practice Location

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