Provider Demographics
NPI:1558655191
Name:KIM, VICTOR LEE (DO)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:LEE
Last Name:KIM
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6655 W SAHARA AVE STE D104
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-0846
Mailing Address - Country:US
Mailing Address - Phone:725-205-2457
Mailing Address - Fax:725-240-7742
Practice Address - Street 1:6655 W SAHARA AVE STE D104
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-0846
Practice Address - Country:US
Practice Address - Phone:725-205-2457
Practice Address - Fax:725-240-7742
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVDO2151207Q00000X
FLOS12867207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV50007OtherMEDICARE