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Individual
CHARLES CHOL BAE KIM
Active
Individual
CHARLES CHOL BAE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
54481
AZ
207QA0505X
Adult Medicine Physician
Primary
C129160
CA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
C-129160
CA
Other
Enumeration date
05/03/2017
Last updated
10/13/2021
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