Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 214160 | MA |
N | 2080P0216X | Pediatric Rheumatologist | 214160 | MA |
Y | 2080P0216X | Pediatric Rheumatologist | C144819 | CA |
NPI | 1417921586 |
---|---|
Provider Name | Dr. Susan Kim |
First Address | San Francisco, CA 94143-2204 |
Second Address | San Francisco, CA 94143-2204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 12/05/2021 |