# SALLY I. KIM, M.D., INC.

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

## Provider details

- **NPI number:** 1699953695
- **Authorized official:** SALLY INJA KIM M.D. (PRESIDENT)
- **Authorized official phone:** (714) 562-5857

## Contact information

- **Practice address:** 5972 BEACH BLVD, BUENA PARK, CA 90621-2024
- **Practice address phone:** (714) 562-5857
- **Practice address fax:** (714) 562-8717
- **Mailing address:** 5972 BEACH BLVD, BUENA PARK, CA 90621-2024
- **Mailing address phone:** (714) 562-5857
- **Mailing address fax:** (714) 562-8717

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | G57460 | CA | Yes |
| 332H00000X | Eyewear Supplier | — | NULL | — |

## Other

- **Enumeration date:** 02/01/2008
- **Last updated:** 06/08/2020