Individual
DR. TAE SUN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11829 SOUTH ST, SUITE 202, CERRITOS, CA 90703-6828
(562) 402-4720
(562) 402-9231
Mailing address
11829 SOUTH ST, SUITE 202, CERRITOS, CA 90703-6828
(562) 402-4720
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G81760
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0091370
—
CA
Enumeration date
02/26/2007
Last updated
07/08/2007
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