Individual
EDWARD KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
620 SHADOW LN, LAS VEGAS, NV 89106-4119
(702) 388-4000
Mailing address
1302 OAK HILL PL, S PASADENA, CA 91030-4045
(213) 999-5537
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
SL1725
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326612839
—
NV
Enumeration date
05/19/2021
Last updated
08/02/2024
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