Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 9445 | MD |
N | 207X00000X | Orthopaedic Surgeon | MD15416 | RI |
Y | 207XS0106X | Orthopaedic Hand Surgeon | A149934 | CA |
NPI | 1003105032 |
---|---|
Provider Name | Thomas Kim |
First Address | Los Altos, CA 94022-1408 |
Second Address | Fremont, CA 94538-2299 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2011 |
Last Update Date | 10/12/2020 |