Soo Y Kim, MD | |
7000 Boulder Ave, Highland, CA 92346-3348 | |
(909) 862-1191 | |
Not Available |
Full Name | Soo Y Kim |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 7000 Boulder Ave, Highland, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295763423 | NPI | - | NPPES |
00A612170 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | A61217 (California) | Primary |
Entity Name | Beaver Medical Group Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649503319 PECOS PAC ID: 0547164295 Enrollment ID: O20031124000449 |
Entity Name | Faculty Physicians And Surgeons Of Llusm |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205009917 PECOS PAC ID: 1153227814 Enrollment ID: O20031211000981 |
Entity Name | Faculty Physicians And Surgeons Of Llusm |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508255175 PECOS PAC ID: 1153227814 Enrollment ID: O20160216002196 |
Mailing Address | Practice Location Address |
---|---|
Soo Y Kim, MD Po Box 10069, San Bernardino, CA 92423-0069 Ph: (909) 335-4188 | Soo Y Kim, MD 7000 Boulder Ave, Highland, CA 92346-3348 Ph: (909) 862-1191 |
Elizabeth Theriault Lion, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4240 Highland Ave, Highland, CA 92346 Phone: 909-864-4700 Fax: 909-864-4300 | |
Atalie M Lim, MD, MBBS Pediatrics Medicare: Medicare Enrolled Practice Location: 4240 Highland Ave, Highland, CA 92346 Phone: 909-864-4700 Fax: 909-425-4195 | |
Dr. Gerald R. Greene, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 7000 Boulder Ave, Highland, CA 92346 Phone: 909-862-1191 Fax: 909-796-4158 | |
Dr. Arthur R. Goyne, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 7000 Boulder Ave, Highland, CA 92346 Phone: 909-862-1191 Fax: 909-796-4158 | |
Dr. Renata Swanston, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 7000 Boulder Ave, Highland, CA 92346 Phone: 909-862-1191 |