Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | A94562 | CA |
NPI | 1063652386 |
---|---|
Provider Name | Dr. Benjamin Kim |
First Address | South San Francisco, CA 94080-4918 |
Second Address | Palo Alto, CA 94304-1601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2009 |
Last Update Date | 01/03/2017 |