Provider Demographics
NPI:1215235676
Name:DAVID K. KIM, MD, INC
Entity type:Organization
Organization Name:DAVID K. KIM, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUETEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-902-8578
Mailing Address - Street 1:490 POST ST
Mailing Address - Street 2:933
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-1401
Mailing Address - Country:US
Mailing Address - Phone:415-773-0800
Mailing Address - Fax:415-986-0816
Practice Address - Street 1:490 POST ST
Practice Address - Street 2:933
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-1401
Practice Address - Country:US
Practice Address - Phone:415-773-0800
Practice Address - Fax:415-986-0816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65349207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty