Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | A113591 | CA |
N | 207R00000X | Internist | A113591 | CA |
N | 111NI0900X | Internist | A113591 | CA |
N | 207RA0201X | Internist - Allergy & Immunology | A113591 | CA |
NPI | 1114160405 |
---|---|
Provider Name | Susan J Kim |
First Address | San Francisco, CA 94121-1604 |
Second Address | San Francisco, CA 94121-1604 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2009 |
Last Update Date | 16/12/2021 |