Kim, Jin Koo

Kim, Jin Koo is an individual health care provider with primary practice located at 2580 Highway 95 Ste 224 , Bullhead City AZ 86442-7332. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Kim, Jin Koo can be contacted via phone (928) 763-7722.

Contact Information

Primary practice address
2580 Highway 95 Ste 224 Bullhead City AZ 86442-7332
Phone: (928) 763-7722
Fax: (928) 763-7744
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 41404 Arizona

Profile Details

NPI number 1467503920
LBN Legal business name Kim, Jin Koo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 12th, 2007
Last updated Feb 7th, 2019 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467503920 NPPES
Arizona MEDICAID 395430

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