Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A129016 | CA |
N | 111NI0900X | Internist | A129016 | CA |
N | 207RC0200X | Critical Care Medicine | A129016 | CA |
Y | 207RP1001X | Pulmonary Disease | A129016 | CA |
NPI | 1063779171 |
---|---|
Provider Name | Lawrence Kim |
First Address | Fullerton, CA 92835-3830 |
Second Address | Fullerton, CA 92835-3830 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2012 |
Last Update Date | 19/10/2020 |