Provider Demographics
NPI:1407810625
Name:KIM, DAVID DOHOON (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DOHOON
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 W SIERRA MADRE BLVD
Mailing Address - Street 2:
Mailing Address - City:SIERRA MADRE
Mailing Address - State:CA
Mailing Address - Zip Code:91024-2492
Mailing Address - Country:US
Mailing Address - Phone:626-355-3443
Mailing Address - Fax:626-355-7843
Practice Address - Street 1:207 S SANTA ANITA AVE
Practice Address - Street 2:SUITE 335
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1146
Practice Address - Country:US
Practice Address - Phone:626-576-1214
Practice Address - Fax:626-458-3387
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC55594207V00000X
IN01059064A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology