Provider Demographics
NPI:1851441208
Name:KIM, THOMAS J (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:140 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-2976
Mailing Address - Country:US
Mailing Address - Phone:908-604-7800
Mailing Address - Fax:973-290-8370
Practice Address - Street 1:11500 W OLYMPIC BLVD STE 150
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1527
Practice Address - Country:US
Practice Address - Phone:424-293-8841
Practice Address - Fax:424-293-8842
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08326900207VE0102X
CAG63902207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology