Individual
DR. VIVIAN Y KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7145 N CHESTNUT AVE, FRESNO, CA 93720-0359
(559) 702-1212
(209) 546-6064
Mailing address
P.O. BOX 25097, FRESNO, CA 93729
(559) 702-1212
(209) 546-6064
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
A65668
CA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
A65668
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A656680
MEDICARE PTAN
CA
Enumeration date
10/10/2006
Last updated
01/08/2018
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