Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | DC0111440 | CA |
NPI | 1538356738 |
---|---|
Provider Name | Dr. Kwang E Kim |
First Address | Los Angeles, CA 90004-2471 |
Second Address | Los Angeles, CA 90004-2471 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2007 |
Last Update Date | 02/10/2007 |