Provider Demographics
NPI:1720249691
Name:KIM, JAMES ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANTHONY
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:801 N TUSTIN AVE STE 507
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3609
Mailing Address - Country:US
Mailing Address - Phone:949-566-8688
Mailing Address - Fax:949-566-8656
Practice Address - Street 1:801 N TUSTIN AVE STE 507
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3609
Practice Address - Country:US
Practice Address - Phone:949-566-8688
Practice Address - Fax:949-566-8656
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA109521207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine