Provider Demographics
NPI:1013340447
Name:KIM, ARTHUR (OD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27540 YNEZ RD STE J15
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-4604
Mailing Address - Country:US
Mailing Address - Phone:951-506-0021
Mailing Address - Fax:951-506-0022
Practice Address - Street 1:27540 YNEZ RD STE J15
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-4604
Practice Address - Country:US
Practice Address - Phone:951-506-0021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10783152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist