Provider Demographics
NPI:1073547626
Name:KIM, NANCY K (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:K
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3663 W. 6TH ST. #307
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-3050
Mailing Address - Country:US
Mailing Address - Phone:213-389-8400
Mailing Address - Fax:213-365-2600
Practice Address - Street 1:3663 W 6TH ST STE 307
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-3050
Practice Address - Country:US
Practice Address - Phone:213-389-8400
Practice Address - Fax:213-365-2600
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75513174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist