Michael Jae Bum Kim
Foot & Ankle Surgery
728 N Euclid Ave
Ontario
, California 91762-2712
Michael Jae Bum Kim
Foot & Ankle Surgery
728 N Euclid Ave
Ontario
, California 91762-2712
(909) 984-5614
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About
Features
Specialties
- Foot & Ankle Surgery
Languages spoken
- English
Location
First Address
- Michael Jae Bum Kim
- 728 N Euclid Ave
- Ontario, CA
- Zip : 91762-2712
- Phone : (909) 984-5614
Second Address
- Michael Jae Bum Kim
- 728 N Euclid Ave
- Ontario, CA
- Zip : 91762-2712
- Phone : (909) 984-5614
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 213ES0103X | Foot & Ankle Surgery | 5901002476 | MI |
| Y | 213ES0103X | Foot & Ankle Surgery | E5294 | CA |
National Provider Identifier
| NPI | 1073951190 |
|---|---|
| Provider Name | Michael Jae Bum Kim |
| First Address | Ontario, CA 91762-2712 |
| Second Address | Ontario, CA 91762-2712 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/06/2013 |
| Last Update Date | 28/06/2016 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.