Individual
DR. DANIEL CHAN KYUM KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
250 E DUNLAP AVE, PHOENIX, AZ 85020-2825
(602) 445-0751
(602) 424-8128
Mailing address
9225 N 3RD ST STE 300, PHOENIX, AZ 85020-2466
(602) 445-0751
(602) 424-8128
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
009558
AZ
208M00000X
Hospitalist Physician
Primary
009558
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009558
AZ DO LICENSE
AZ
05
—
153907
—
AZ
Enumeration date
04/05/2019
Last updated
07/12/2022
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