Provider Demographics
NPI:1265646731
Name:HYO KIM, M.D.,INC.
Entity Type:Organization
Organization Name:HYO KIM, M.D.,INC.
Other - Org Name:QUANTUM PHYSICAL MEDICINE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HYO
Authorized Official - Middle Name:H
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-989-5010
Mailing Address - Street 1:2022 NORTH RD SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-3301
Mailing Address - Country:US
Mailing Address - Phone:330-989-5010
Mailing Address - Fax:330-989-5019
Practice Address - Street 1:2022 NORTH RD SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-3301
Practice Address - Country:US
Practice Address - Phone:330-989-5010
Practice Address - Fax:330-989-5019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35056977174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2068775Medicaid
OH9301691Medicare PIN
OHB48089Medicare UPIN
OH2068775Medicaid