Provider Demographics
NPI:1770514465
Name:KIM, MATTHEW H (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:H
Last Name:KIM
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Gender:
Credentials:MD
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Mailing Address - Street 1:270 LAGUNA RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-2521
Mailing Address - Country:US
Mailing Address - Phone:714-525-2375
Mailing Address - Fax:714-871-9280
Practice Address - Street 1:270 LAGUNA RD
Practice Address - Street 2:SUITE 100
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-2521
Practice Address - Country:US
Practice Address - Phone:714-525-2375
Practice Address - Fax:714-871-9280
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2025-02-21
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Provider Licenses
StateLicense IDTaxonomies
CAA94998207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA94998CMedicare UPIN