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Individual

DR. CHANG S. KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1310 LAS TABLAS RD, SUITE 103, TEMPLETON, CA 93465-9737
(805) 461-7080
(805) 464-0243
Mailing address
PO BOX 2920, ATASCADERO, CA 93423-2920
(805) 461-7080
(805) 464-0243

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A34156
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A341560
CA
Enumeration date
02/16/2006
Last updated
12/06/2007
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