Kim, Kyoung Ae

Kim, Kyoung Ae is an individual health care provider with primary practice located at 1211 W La Palma Ave Suite 207, Anaheim CA 92801-2815. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Kim, Kyoung Ae can be contacted via phone (714) 772-8282.

Contact Information

Primary practice address
1211 W La Palma Ave Suite 207 Anaheim CA 92801-2815
Phone: (714) 772-8282
Fax: (714) 772-6493
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X A110263 California
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A110263 California

Profile Details

NPI number 1477882215
LBN Legal business name Kim, Kyoung Ae
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2009
Last updated Dec 2nd, 2010 - about 14 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 1477882215 NPPES
California MEDICAID 00A1102630

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