Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 43993 | CA |
NPI | 1003965963 |
---|---|
Provider Name | Dr. Joseph Sunil Kim |
First Address | Mountain View, CA 94040-2804 |
Second Address | Mountain View, CA 94040-2804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 08/07/2007 |