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Individual

DR. JAI KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4524 N MARYVALE PKWY STE 220, PHOENIX, AZ 85031
(238) 463-1866
(623) 846-3757
Mailing address
4524 N MARYVALE PKWY STE 220, PHOENIX, AZ 85031-1732
(623) 846-3186
(623) 846-3757

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
233212
NY
207Q00000X
Family Medicine Physician
Primary
52931
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02613789
NY
Enumeration date
06/21/2006
Last updated
07/02/2018
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