MEDICARE: DR. DAVID W 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
1	207Y00000X	Otolaryngology Physician	A65349	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1922066075	OTHER	CA	NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922066075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID W KIM MD

Provider Business Mailing Address
First Line	:	490 POST ST
Second Line	:	STE. 933
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-1401
Country	:	US
Telephone Number	:	415-773-0800
Fax Number	:	415-986-0816

Provider Business Practice Location Address
First Line	:	490 POST ST
Second Line	:	STE. 933
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-1401
Country	:	US
Telephone Number	:	415-773-0800
Fax Number	:	415-986-0816

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

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	03/04/2011

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