Organization
KENNETH K. KIM, M.D., A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH K. KIM M.D. (CEO)
(310) 882-8482
Entity
Organization
Contact information
Practice address
5757 WILSHIRE BLVD, SUITE 348, LOS ANGELES, CA 90036-5810
(213) 700-4297
(323) 424-4080
Mailing address
5757 WILSHIRE BLVD, SUITE 348, LOS ANGELES, CA 90036-5810
(213) 700-4297
(323) 424-4080
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
A81964
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A81964
STATE LICENSE
CA
Enumeration date
12/02/2008
Last updated
05/06/2015
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