Provider Demographics
NPI:1962475624
Name:KIM, BO K (MD)
Entity Type:Individual
Prefix:
First Name:BO
Middle Name:K
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:145 VISTA AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3607
Mailing Address - Country:US
Mailing Address - Phone:626-397-8335
Mailing Address - Fax:626-397-8350
Practice Address - Street 1:55 E CALIFORNIA BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3954
Practice Address - Country:US
Practice Address - Phone:626-449-7350
Practice Address - Fax:626-449-1321
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2021-11-30
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Provider Licenses
StateLicense IDTaxonomies
CAA70312208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics