Organization
TAE HYUN KIM DPM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAE H KIM D.P.M. (PRESIDENT)
(818) 997-1216
Entity
Organization
Contact information
Practice address
13701 BURBANK BLVD, VAN NUYS, CA 91401-5040
(818) 997-1216
(818) 997-4458
Mailing address
13701 BURBANK BLVD, VAN NUYS, CA 91401-5040
(818) 997-1216
(818) 997-4458
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4262
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E4262
STATE LICENSE
CA
Enumeration date
08/17/2009
Last updated
11/02/2009
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