Provider Demographics
NPI:1710129093
Name:KIM, PAUL SEUNG KI (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:SEUNG KI
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 1:1950 S SUNWEST LN
Mailing Address - Street 2:STE 108
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3263
Mailing Address - Country:US
Mailing Address - Phone:909-521-8818
Mailing Address - Fax:909-521-9854
Practice Address - Street 1:1950 S SUNWEST LN
Practice Address - Street 2:STE 108
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3263
Practice Address - Country:US
Practice Address - Phone:909-521-8818
Practice Address - Fax:909-521-9854
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2023-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA114242174400000X, 2083X0100X, 208D00000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No174400000XOther Service ProvidersSpecialist
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice