Provider Demographics
NPI:1942568852
Name:KIM, CANDICE JINHEE (MD)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:JINHEE
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25395 HANCOCK AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-9054
Mailing Address - Country:US
Mailing Address - Phone:951-677-6670
Mailing Address - Fax:951-677-6676
Practice Address - Street 1:25395 HANCOCK AVE STE 230
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-9054
Practice Address - Country:US
Practice Address - Phone:951-677-6670
Practice Address - Fax:951-677-6676
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-27
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA129281207UN0901X
CAA129381207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology