Kim, Bong Sup
Kim, Bong Sup is an sole proprietor health care provider with primary practice located at 15208 Aurora Ave N , Shoreline WA 98133-6124. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Kim, Bong Sup can be contacted via phone (206) 362-3361.Contact Information
Primary practice address
15208 Aurora Ave N
Shoreline WA 98133-6124
Phone: (206) 362-3361
Fax: (206) 362-7055
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD00023608 | Washington |
Profile Details
| NPI number | 1336225432 |
|---|---|
| LBN Legal business name | Kim, Bong Sup |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 31st, 2006 |
| Last updated | Dec 14th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336225432 | NPPES |
| Washington | MEDICAID | 1068048 |
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