Individual
DR. JOHNATHAN JONGHYUN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(909) 558-4074
Mailing address
300 PASTEUR DR, STANFORD, CA 94305-2200
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A149386
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
216005344
UIN
TX
Enumeration date
06/17/2015
Last updated
08/20/2020
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