Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | A36422 | CA |
NPI | 1013932136 |
---|---|
Provider Name | Yang J Kim |
First Address | Fresno, CA 93720-3637 |
Second Address | Fresno, CA 93720-3309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 21/09/2011 |