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Individual
DR. ALISA KIM
Active
Individual
DR. ALISA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
D61666
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
178540YGP3
MEDICARE PTAN
DC
01
—
243873
MEDICARE PTAN
MD
01
—
243875
MEDICARE PTAN
MD
05
—
405809700
—
MD
Enumeration date
06/09/2006
Last updated
12/01/2023
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