Individual
DR. ILKWON KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
412 S WILTON PL APT 402, LOS ANGELES, CA 90020-4586
(121) 380-0101
(213) 800-1010
Mailing address
412 S. WILTON PLACE, UNIT 402, LOS ANGELES, CA 90020
12138001010
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
C50652
CA
208D00000X
General Practice Physician
C50652
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D3254925
DRIVERS LICENSE
CA
Enumeration date
02/03/2006
Last updated
03/17/2018
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