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Individual

BRIAN TAKEMOTO KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
24401 CALLE DE LA LOUISA, SUITE 300, LAGUNA HILLS, CA 92653-3623
(949) 951-2020
(949) 356-1687
Mailing address
24401 CALLE DE LA LOUISA, SUITE 300, LAGUNA HILLS, CA 92653-3623
(949) 951-2020
(949) 356-1687

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A111328
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A111328
MEDICAL LICENSE
CA
01
R70250
TRAINING PERMIT
AZ
Enumeration date
06/16/2008
Last updated
02/12/2014
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