Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | G85388 | CA |
NPI | 1013023365 |
---|---|
Provider Name | Hyun Sil Kim |
First Address | San Diego, CA 92123-4205 |
Second Address | San Diego, CA 92123-4205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 10/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G67330 | (02) | |
GR0027570 | (05) | CA |