Provider Demographics
NPI:1124319132
Name:KIM, FRANK (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 E 78TH ST
Mailing Address - Street 2:#2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-2235
Mailing Address - Country:US
Mailing Address - Phone:301-529-3748
Mailing Address - Fax:
Practice Address - Street 1:20055 LAKE CHABOT RD STE 300
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5334
Practice Address - Country:US
Practice Address - Phone:510-538-7738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2544972084N0400X
CAA1000432084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology