Provider Demographics
NPI:1790904852
Name:KIM, STEVE SEOG (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:SEOG
Last Name:KIM
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 S LA CIENEGA BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3328
Mailing Address - Country:US
Mailing Address - Phone:310-553-5315
Mailing Address - Fax:310-854-0122
Practice Address - Street 1:239 S LA CIENEGA BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3328
Practice Address - Country:US
Practice Address - Phone:310-553-5315
Practice Address - Fax:310-854-0122
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA774952086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery