Provider Demographics
NPI:1346876505
Name:HUYNH, KIM (MS)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:HUYNH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2149 MENDOCINO BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-2355
Mailing Address - Country:US
Mailing Address - Phone:858-997-7415
Mailing Address - Fax:
Practice Address - Street 1:7071 CONSOLIDATED WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2604
Practice Address - Country:US
Practice Address - Phone:858-997-7415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-19
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty