Provider Demographics
NPI:1568677573
Name:KIM, JAMES D (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 25140
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85285-5140
Mailing Address - Country:US
Mailing Address - Phone:415-265-4069
Mailing Address - Fax:831-621-4769
Practice Address - Street 1:4441 E MCDOWELL RD STE 101
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-4503
Practice Address - Country:US
Practice Address - Phone:415-265-4069
Practice Address - Fax:831-621-4769
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA98699207L00000X
AZ43612207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology