Provider Demographics
NPI:1164622742
Name:KIM, JUDY MIHYUN (MD)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:MIHYUN
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 1:3323 W OLYMPIC BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-2339
Mailing Address - Country:US
Mailing Address - Phone:323-735-1111
Mailing Address - Fax:323-735-3306
Practice Address - Street 1:3323 W OLYMPIC BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-2339
Practice Address - Country:US
Practice Address - Phone:323-735-1111
Practice Address - Fax:323-735-3306
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83503207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine