Individual
DR. WARREN TACKHOON KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
1100 VAN NESS AVE, SAN FRANCISCO, CA 94109-6978
(415) 600-0528
(415) 369-1207
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(415) 600-0528
(415) 369-1207
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
893219
CA
2085N0700X
Neuroradiology Physician
A91921
CA
2085R0202X
Diagnostic Radiology Physician
893219
CA
2085R0202X
Diagnostic Radiology Physician
A91921
CA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
A91921
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063532778
—
CA
01
—
A91921
STATE MEDICAL LICENSE
CA
01
—
P01266715
RAILROAD MEDICARE
CA
Enumeration date
03/29/2007
Last updated
01/11/2021
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