Individual
HACK JAE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2680 S VAL VISTA DR STE 116, GILBERT, AZ 85295-2154
(480) 507-5678
(480) 507-5677
Mailing address
3707 N 7TH ST STE 200, PHOENIX, AZ 85014-5095
(480) 507-5678
(480) 507-5677
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
32877
AZ
207RI0008X
Hepatology Physician
32877
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
865123
—
AZ
Enumeration date
11/29/2005
Last updated
03/07/2014
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