Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | A91209 | CA |
NPI | 1033291562 |
---|---|
Provider Name | Daniel Jae Kim |
First Address | Los Angeles, CA 90051-0185 |
Second Address | South Pasadena, CA 91030-1814 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 09/11/2020 |