Provider Demographics
NPI:1235451360
Name:KIM, JANET BONNIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:BONNIE
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 1:26302 LA PAZ RD #106
Mailing Address - Street 2:STE 106
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-5380
Mailing Address - Country:US
Mailing Address - Phone:949-328-9972
Mailing Address - Fax:949-328-9976
Practice Address - Street 1:26302 LA PAZ RD #106
Practice Address - Street 2:STE 106
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5380
Practice Address - Country:US
Practice Address - Phone:949-328-9972
Practice Address - Fax:949-328-9976
Is Sole Proprietor?:No
Enumeration Date:2010-02-16
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG82040207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology