MEDICARE: KATHRYN KIM

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	207L00000X	Anesthesiology Physician	A197693	CA

General Provider Information

NPI Number	:	1720665789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN KIM

Provider Business Mailing Address
First Line	:	757 WESTWOOD PLZ
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-7419
Country	:	US
Telephone Number	:	310-267-8655
Fax Number	:

Provider Business Practice Location Address
First Line	:	757 WESTWOOD PLZ
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-2627
Country	:	US
Telephone Number	:	310-267-8655
Fax Number	:

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

Provider Enumeration Date	:	03/25/2021
Last Update Date	:	02/24/2025

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Directions to “ KATHRYN KIM ” Practice Location

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