Individual
GRACE L KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
805 AEROVISTA PL, SUITE 106, SAN LUIS OBISPO, CA 93401-7919
(805) 541-1595
(805) 594-1241
Mailing address
PO BOX 6406, SANTA MARIA, CA 93456-6406
(805) 928-1731
(805) 349-8160
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A48699
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A486990
—
CA
Enumeration date
09/22/2005
Last updated
01/23/2026
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