Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | A75099 | CA |
Y | 207X00000X | Orthopaedic Surgeon | A75099 | CA |
NPI | 1437354263 |
---|---|
Provider Name | Dr. Todd S Kim |
First Address | Los Altos, CA 94022-1408 |
Second Address | Burlingame, CA 94010-4506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2007 |
Last Update Date | 19/06/2020 |