Provider Demographics
NPI:1528223492
Name:KIM, CHUL (DPM)
Entity Type:Individual
Prefix:DR
First Name:CHUL
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3400 LOMITA BLVD
Mailing Address - Street 2:SUITE 403
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4909
Mailing Address - Country:US
Mailing Address - Phone:310-326-8551
Mailing Address - Fax:310-326-3363
Practice Address - Street 1:3400 LOMITA BLVD
Practice Address - Street 2:SUITE 403
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4909
Practice Address - Country:US
Practice Address - Phone:310-326-8551
Practice Address - Fax:310-326-3363
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE4825213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery