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Individual

JEONG H KIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1401 S BERETANIA ST STE 320, HONOLULU, HI 96814-1872
(808) 888-0967
(808) 888-0956
Mailing address
587 MOANIALA ST, HONOLULU, HI 96821-2571
(808) 489-9479
(808) 888-0956

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
54642
WI
207RG0100X
Gastroenterology Physician
AFE73901
CA
207RG0100X
Gastroenterology Physician
Primary
MD-16105
HI
207RG0100X
Gastroenterology Physician
MD00047928
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
227617
LABOR & INDUSTRIES
WA
05
8501496
WA
01
9185KI
REGENCE BLUE SHIELD
01
9275116
AETNA
Enumeration date
08/08/2006
Last updated
03/07/2023
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