Provider Demographics
NPI:1437444247
Name:KIM, GINA J (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:J
Last Name:KIM
Suffix:
Gender:F
Credentials:MD, MPH
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Mailing Address - Street 1:3701 WILSHIRE BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2814
Mailing Address - Country:US
Mailing Address - Phone:323-361-3550
Mailing Address - Fax:323-361-8052
Practice Address - Street 1:4650 SUNSET BLVD MS #3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6062
Practice Address - Country:US
Practice Address - Phone:323-361-5918
Practice Address - Fax:323-361-3642
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2016-06-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA130067207P00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics