Provider Demographics
NPI:1184608259
Name:KIM, DAVID SEIL (MD, MS, MBA)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SEIL
Last Name:KIM
Suffix:
Gender:M
Credentials:MD, MS, MBA
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Other - Credentials:
Mailing Address - Street 1:PO BOX 512717
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-0717
Mailing Address - Country:US
Mailing Address - Phone:310-423-2914
Mailing Address - Fax:310-423-0313
Practice Address - Street 1:444 S SAN VICENTE BLVD
Practice Address - Street 2:STE 1003
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-4165
Practice Address - Country:US
Practice Address - Phone:310-423-9268
Practice Address - Fax:310-423-1272
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-02
Last Update Date:2013-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC53881207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACY196ZMedicare Oscar/Certification