Provider Demographics
NPI:1255431300
Name:KIM, YUN J (MD)
Entity type:Individual
Prefix:MRS
First Name:YUN
Middle Name:J
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-0190
Mailing Address - Country:US
Mailing Address - Phone:714-228-1888
Mailing Address - Fax:714-676-8308
Practice Address - Street 1:5832 BEACH BLVD UNIT 109A
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-5500
Practice Address - Country:US
Practice Address - Phone:714-228-1888
Practice Address - Fax:714-676-8308
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA62158207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A621580Medicaid
CA00A621580Medicaid
H33983Medicare UPIN