Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | E5028 | CA |
NPI | 1144582842 |
---|---|
Provider Name | Jaehyun Kim |
First Address | San Francisco, CA 94103-5539 |
Second Address | Sunnyvale, CA 94087-2657 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2012 |
Last Update Date | 15/07/2013 |