Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 285216 | NY |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | A159497 | CA |
NPI | 1184069296 |
---|---|
Provider Name | Dr. Youngho Paul Kim |
First Address | San Diego, CA 92121-1518 |
Second Address | New York, NY 10065-6007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2013 |
Last Update Date | 22/01/2020 |