Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 260246-1 | NY |
Y | 208800000X | Urologist | A100044 | CA |
NPI | 1023269461 |
---|---|
Provider Name | Dr. Philip Hyunwoo Kim |
First Address | San Diego, CA 92120-3315 |
Second Address | San Diego, CA 92120-3315 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2008 |
Last Update Date | 04/11/2021 |