Individual
STEVEN PARK KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
4761 HOEN AVE, SANTA ROSA, CA 95405-7862
(707) 545-0570
(707) 545-0575
Mailing address
3536 MENDOCINO AVE, 200, SANTA ROSA, CA 95403-3634
(707) 575-6049
(707) 545-0575
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4506
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E45060
—
CA
01
—
P01011615
RAILROAD MEDICARE
CA
Enumeration date
07/05/2006
Last updated
04/18/2012
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