K.w. Kim, A Professional Corp | |
1205 Evergreen Street Selma CA 93662 | |
(559) 896-2342 | |
Not Available |
Full Name | K.w. Kim, A Professional Corp |
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Speciality | Internal Medicine |
Location | 1205 Evergreen Street, Selma, California |
Authorized Official Name and Position | Kil Woo Kim (PRESIDENT) |
Authorized Official Contact | 5598962342 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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K.w. Kim, A Professional Corp P.o. Box 1139 Selma CA 93662 Ph: (559) 896-2342 | K.w. Kim, A Professional Corp 1205 Evergreen Street Selma CA 93662 Ph: (559) 896-2342 |
NPI Number | 1437482676 |
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Provider Enumeration Date | 09/04/2009 |
Last Update Date | 09/04/2009 |
Medicare PECOS PAC ID | 4688720212 |
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Medicare Enrollment ID | O20090922000779 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437482676 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | A340310 (California) | Primary |
Provider Name | Kil Woo Kim |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1205847993 PECOS PAC ID: 1052467685 Enrollment ID: I20090922000776 |
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