| Dr. Yong H. Kim, Psyd, Professional Limited Company | |
|
8101 Nw 10th Oklahoma City OK 73127 | |
| (405) 365-7556 | |
| Not Available |
| Full Name | Dr. Yong H. Kim, Psyd, Professional Limited Company |
|---|---|
| Speciality | Psychologist |
| Location | 8101 Nw 10th, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Yong H. Kim (PSYCHOLOGIST) |
| Authorized Official Contact | 4053657556 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Yong H. Kim, Psyd, Professional Limited Company 13004 Willowcrest Ln. Oklahoma City OK 73170 Ph: (405) 365-7556 | Dr. Yong H. Kim, Psyd, Professional Limited Company 8101 Nw 10th Oklahoma City OK 73127 Ph: (405) 365-7556 |
| NPI Number | 1437494655 |
|---|---|
| Provider Enumeration Date | 11/28/2012 |
| Last Update Date | 11/28/2012 |
| Medicare PECOS PAC ID | 4284919531 |
|---|---|
| Medicare Enrollment ID | O20170328002588 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437494655 | NPI | - | NPPES |
| 200304690 | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1109 (Oklahoma) | Primary |
| Provider Name | Yong H Kim |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003120973 PECOS PAC ID: 4688863921 Enrollment ID: I20110118000879 |
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