Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 22048 | MN |
Y | 2080P0210X | Pediatric Nephrologist | 22048 | MN |
NPI | 1689764144 |
---|---|
Provider Name | Youngki Kim |
First Address | Minneapolis, MN 55455 |
Second Address | Minneapolis, MN 55455-0356 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 26/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0012087 | (05) | MT |
053926 | FAIRVIEW (01) | MN |
0990457 | (05) | IA |
101068 | U CARE (01) | MN |
1012191 | PREFERRED ONE (01) | MN |
10387 | (05) | ND |
2104458 | (05) | OH |
2T291KI | BCBS (01) | MN |
30200800 | (05) | WI |
3107051 | MEDICA-CHOICE (01) | MN |
3107051 | MEDICA-PRIMARY (01) | MN |
64421308 | (05) | KY |
685883000 | (05) | MN |
768197 | ARAZ (01) | |
7777470 | (05) | SD |
A063 | CHAMPUS/TRIWEST (01) | |
D82160 | (02) | |
HP21987 | HEALTH PARTNERS (01) | MN |