Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A82293 | CA |
Y | 207X00000X | Orthopaedic Surgeon | M6705 | TX |
N | 207XS0117X | Orthopaedic Spine Surgeon | A82293 | CA |
N | 207XS0117X | Orthopaedic Spine Surgeon | M6705 | TX |
NPI | 1295753309 |
---|---|
Provider Name | Youjeong Kim |
First Address | San Francisco, CA 94115-2374 |
Second Address | San Francisco, CA 94115-2374 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 18/06/2020 |