Provider Demographics
NPI:1942573233
Name:KIM, SOOK H (DO)
Entity Type:Individual
Prefix:MS
First Name:SOOK
Middle Name:H
Last Name:KIM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6302 SAN RUBEN CIR
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-3638
Mailing Address - Country:US
Mailing Address - Phone:310-562-4063
Mailing Address - Fax:
Practice Address - Street 1:220 NEWPORT CENTER DR STE 20
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7508
Practice Address - Country:US
Practice Address - Phone:949-719-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-16
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist