| James J Kim, M.d., Inc | |
|
520 S Virgil Ave Suite 307 Los Angeles CA 90020-1416 | |
| (213) 386-2500 | |
| (213) 386-6787 |
| Full Name | James J Kim, M.d., Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 520 S Virgil Ave, Los Angeles, California |
| Authorized Official Name and Position | James J Kim (PRESIDENT) |
| Authorized Official Contact | 2133862500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James J Kim, M.d., Inc 520 S Virgil Ave Suite 307 Los Angeles CA 90020-1416 Ph: (213) 386-2500 | James J Kim, M.d., Inc 520 S Virgil Ave Suite 307 Los Angeles CA 90020-1416 Ph: (213) 386-2500 |
| NPI Number | 1053475608 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 08/10/2011 |
| Medicare PECOS PAC ID | 1456392539 |
|---|---|
| Medicare Enrollment ID | O20050518001263 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053475608 | NPI | - | NPPES |
| 00A490110 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0402X | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology | A49011 (California) | Primary |
| Provider Name | James J Kim |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033268941 PECOS PAC ID: 0143123695 Enrollment ID: I20050518001275 |
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