Provider Demographics
NPI:1285627224
Name:KIM, FRANK H (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:H
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:801 S MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-3410
Mailing Address - Country:US
Mailing Address - Phone:951-735-2700
Mailing Address - Fax:951-735-7564
Practice Address - Street 1:801 S MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-3410
Practice Address - Country:US
Practice Address - Phone:951-735-2700
Practice Address - Fax:951-735-7564
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIFK072217208800000X
AL33113208800000X
CAG87046208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI340019578OtherTRICARE
MI340G310500OtherBLUE CROSS
MI4153053Medicaid
AL159278Medicaid
MI0982255OtherHEALTHPLUS
MI5162198OtherAETNA
MI340015653OtherRAILROAD MEDICARE
MI4153071Medicaid
CA00G870460OtherMEDICARE CALIFORNIA
MIF02919Medicare UPIN