Provider Demographics
NPI:1164588760
Name:KIM, HEI PAIK (MD)
Entity Type:Individual
Prefix:MR
First Name:HEI
Middle Name:PAIK
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3663 W 6TH ST
Mailing Address - Street 2:#203
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020
Mailing Address - Country:US
Mailing Address - Phone:213-480-1251
Mailing Address - Fax:213-365-5985
Practice Address - Street 1:3663 W 6TH ST
Practice Address - Street 2:#203
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020
Practice Address - Country:US
Practice Address - Phone:213-480-1251
Practice Address - Fax:213-365-5985
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA33208207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A332082Medicaid
A27071Medicare UPIN
CAA33208Medicare Oscar/Certification