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Individual
DR. DANA JEAN KIM
Active
Individual
DR. DANA JEAN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D64378
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BK9853498
CONTROLLED SUBSTANCE REG
MD
01
—
D64378
PHYSICIAN LICENSE
MD
01
—
M60604
CONTROLLED DANGEROUS SUBS
MD
Enumeration date
10/18/2006
Last updated
07/08/2007
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