Individual
BRIAN TAKEMOTO KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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