Organization
PAUL S KIM AND KIRK L OHANIAN,MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRK L OHANIAN M.D. (PRESIDENT)
(949) 489-4507
Entity
Organization
Contact information
Practice address
654 CAMINO DE LOS MARES, SAN CLEMENTE, CA 92673-2827
(949) 489-4507
(949) 489-4657
Mailing address
DEPT LA 21586, PASADENA, CA 91185-0001
(949) 489-4507
(949) 489-4657
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0101710
—
CA
01
—
ZZZ09164Z
BLUE SHIELD
CA
01
—
ZZZ65273Z
BLUE SHIELD
CA
Enumeration date
05/17/2006
Last updated
08/18/2008
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