Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 24811 | CA |
Y | 213EG0000X | General Practice | 24811 | CA |
NPI | 1003870437 |
---|---|
Provider Name | Dr. Dong K Kim |
First Address | Torrance, CA 90501-2837 |
Second Address | Torrance, CA 90501-2837 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 08/07/2007 |