Provider Demographics
NPI:1780864504
Name:KIM, EUGENE K (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:K
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:200 S MANCHESTER AVE
Mailing Address - Street 2:SUITE 650
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3217
Mailing Address - Country:US
Mailing Address - Phone:714-456-5755
Mailing Address - Fax:714-456-7718
Practice Address - Street 1:200 S MANCHESTER AVE
Practice Address - Street 2:SUITE 650
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3217
Practice Address - Country:US
Practice Address - Phone:714-456-5755
Practice Address - Fax:714-456-7718
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA99140208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery