Individual
STACEY KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8700 BEVERLY BLVD, SOUTH TOWER, ROOM 8709, LOS ANGELES, CA 90048
(310) 423-6941
Mailing address
8700 BEVERLY BLVD, SOUTH TOWER, ROOM 8709, LOS ANGELES, CA 90048
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
115491
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
LP01253
RI
Other
Enumeration date
06/26/2007
Last updated
07/20/2011
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