MEDICARE: DUK HWAN 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
1	2084N0400X	Neurology Physician	A78546	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00605841	OTHER	CA	RAILROAD MEDICARE
2	W6126	OTHER	CA	MEDICARE GROUP PTAN

Other Identifiers

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

General Provider Information

NPI Number	:	1760423354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUK HWAN KIM M.D.

Provider Business Mailing Address
First Line	:	8622 MASTERS DR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92646-4524
Country	:	US
Telephone Number	:	714-855-4989
Fax Number	:	714-418-5789

Provider Business Practice Location Address
First Line	:	8622 MASTERS DR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92646-4524
Country	:	US
Telephone Number	:	714-855-4989
Fax Number	:	714-418-5789

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	04/11/2017

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Directions to “ DUK HWAN KIM M.D.” Practice Location

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