Provider Demographics
NPI:1659402071
Name:COYE, JISUE KIM (MD)
Entity Type:Individual
Prefix:DR
First Name:JISUE
Middle Name:KIM
Last Name:COYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JISUE
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:20911 EARL ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4352
Mailing Address - Country:US
Mailing Address - Phone:310-370-7759
Mailing Address - Fax:310-370-1590
Practice Address - Street 1:20911 EARL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4352
Practice Address - Country:US
Practice Address - Phone:310-370-7759
Practice Address - Fax:310-370-1590
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77163208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics