# KITAE KIM MD LTD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SPECIAL ASSOCIATES IN SURGERY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346976750
- **Authorized official:** KITAE KIM MD (PRESIDENT)
- **Authorized official phone:** (702) 629-3771

## Contact information

- **Practice address:** 3061 S MARYLAND PKWY STE 104, LAS VEGAS, NV 89109-6226
- **Practice address phone:** (702) 629-3771
- **Practice address fax:** (702) 438-6666
- **Mailing address:** 2657 WINDMILL PKWY \# 685, HENDERSON, NV 89074-3384
- **Mailing address phone:** (702) 629-3771
- **Mailing address fax:** (702) 438-6666

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 2086S0102X | Surgical Critical Care Physician | — | NULL | Yes |
| 2086S0102X | Surgical Critical Care Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/27/2022
- **Last updated:** 07/27/2022