Individual
KWANG SOO KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
651 FULTON AVE, SACRAMENTO, CA 95825-4813
(916) 483-2525
Mailing address
651 FULTON AVE, SACRAMENTO, CA 95825-4813
(916) 483-2525
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A91190
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00282743
RAILROAD MEDICARE
—
Enumeration date
02/27/2007
Last updated
01/30/2012
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