Individual
LORI CRYSTAL KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
820 LAS GALLINAS AVE, SAN RAFAEL, CA 94903-3410
(415) 446-2500
Mailing address
820 LAS GALLINAS AVE, SAN RAFAEL, CA 94903-3410
(415) 446-2500
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
A109816
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09164
BCBS
FL
05
—
280072100
—
FL
Enumeration date
10/24/2007
Last updated
11/14/2024
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