Individual
PAUL J. KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2895 EDINGER AVE, TUSTIN, CA 92780-7257
(949) 381-5800
(949) 552-5152
Mailing address
FILE 749267, LOS ANGELES, CA 90074-9267
(877) 207-9454
(615) 691-7497
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
0101247041
VA
2085R0001X
Radiation Oncology Physician
Primary
A93398
CA
2085R0001X
Radiation Oncology Physician
L-239140
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10059062
OPTIMA HEALTH
VA
01
—
1629205190
TRICARE
VA
05
—
1629205190
—
VA
01
—
401734
ANTHEM BC/BS (FIRST COLONIAL RD)
VA
01
—
401737
ANTHEM BC/BS (GRESHAM DR.)
VA
01
—
401742
ANTHEM BC/BS (GLENN MITCHELL DR.)
VA
01
—
401745
ANTHEM BC/BS (LAKE WRIGHT DR.)
VA
05
—
5914173
—
NC
01
—
PAR
CIGNA
VA
Enumeration date
06/11/2009
Last updated
02/22/2017
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