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Individual

CHANG KYUN KIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1600 W AVENUE J, LANCASTER, CA 93534-2814
(661) 949-5000
(661) 949-5971
Mailing address
101 S 1ST ST, 1000, BURBANK, CA 91502-1938
(818) 845-6206
(818) 845-9774

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A34966
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A349660
BLUE SHIELD
CA
05
00A349660
CA
Enumeration date
07/28/2006
Last updated
07/08/2007
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