Individual
PAUL SUNGYUL KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G77030
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G770300
BLUE SHIELD
CA
05
—
00G770300
—
CA
01
—
00G770300159
CALOPTIMA
CA
01
—
00G770301
BLUE SHIELD
CA
Enumeration date
05/12/2006
Last updated
08/19/2008
Update your record
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