Provider Demographics
NPI:1164060091
Name:KIM, HOON YUB (MD, PHD, FACS)
Entity Type:Individual
Prefix:DR
First Name:HOON YUB
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:MD, PHD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:KORYEODAE-RO 73
Mailing Address - Street 2:KOREA UNIVERSITY COLLEGE OF MEDICINE
Mailing Address - City:SEONGBUK-GU
Mailing Address - State:SEOUL
Mailing Address - Zip Code:02841
Mailing Address - Country:KR
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1430 TULANE AVE # SL-22
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2632
Practice Address - Country:US
Practice Address - Phone:109-163-2829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA321527208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery