# STANLEY S. KIM, M.D.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073791687
- **Authorized official:** DR. STANLEY S. KIM M.D. (OWNER)
- **Authorized official phone:** (213) 385-8500

## Contact information

- **Practice address:** 3663 W 6TH ST, SUITE \#200, LOS ANGELES, CA 90020-3049
- **Practice address phone:** (213) 385-8500
- **Practice address fax:** (213) 385-4896
- **Mailing address:** 3663 W 6TH ST, SUITE \#200, LOS ANGELES, CA 90020-3049
- **Mailing address phone:** (213) 385-8500
- **Mailing address fax:** (213) 385-4896

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | G54395 | CA | Yes |

## Other

- **Enumeration date:** 02/06/2008
- **Last updated:** 02/06/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00G543950 | — | CA |
| 05 | — | 00G543951 | — | CA |
| 01 | — | 1050960002 | MEDICARE DMEPOS SUPPLIER | CA |