Individual
JASON KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18511 HIGHLANDER MEDICS ST, FORT BLISS, TX 79906-5327
(915) 742-7777
Mailing address
505 PARNASSUS AVE, SAN FRANCISCO, CA 94143-2204
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101268517
VA
2085R0202X
Diagnostic Radiology Physician
036176652
IL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
W0202
TX
208D00000X
General Practice Physician
0101268517
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/27/2018
Last updated
03/03/2026
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