Individual
DR. DONG H KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4241 LONG BEACH BLVD, RAD-IMAGE MEDICAL GROUP INC., LONG BEACH, CA 90807-2003
(562) 912-2507
(484) 918-2507
Mailing address
4241 LONG BEACH BLVD, RAD-IMAGE MEDICAL GROUP INC., LONG BEACH, CA 90807-2003
(562) 912-2507
(484) 918-2507
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A112453
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A1124530
BLUE SHIELD OF CA
CA
05
—
1457633919
—
CA
Enumeration date
09/12/2011
Last updated
06/04/2013
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