Organization
STANLEY S. KIM, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANLEY S. KIM M.D. (OWNER)
(213) 385-8500
Entity
Organization
Contact information
Practice address
3663 W 6TH ST, SUITE #200, LOS ANGELES, CA 90020-3049
(213) 385-8500
(213) 385-4896
Mailing address
3663 W 6TH ST, SUITE #200, LOS ANGELES, CA 90020-3049
(213) 385-8500
(213) 385-4896
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
G54395
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G543950
—
CA
05
—
00G543951
—
CA
01
—
1050960002
MEDICARE DMEPOS SUPPLIER
CA
Enumeration date
02/06/2008
Last updated
02/06/2008
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