| Dr Michael Jin Kim, MD | |
| 101 Bodin Cir, Travis Afb, CA 94535-1809 | |
| (707) 423-3749 | |
| Not Available | 
| Full Name | Dr Michael Jin Kim | 
|---|---|
| Gender | Male | 
| Speciality | Family Medicine | 
| Location | 101 Bodin Cir, Travis Afb, California | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1609289636 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207P00000X | Emergency Medicine | 036143899 (Illinois) | Secondary | 
| 207Q00000X | Family Medicine | 036.143899 (Illinois) | Primary | 
| Entity Name | Cepamerica Illinois Llp | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1912283110 PECOS PAC ID: 3274793633 Enrollment ID: O20120322000587 | 
| Entity Name | Vituity - Illinois Auc Llp | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1306334198 PECOS PAC ID: 0547516932 Enrollment ID: O20180627000637 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Michael Jin Kim, MD 101 Bodin Cir, Travis Afb, CA 94535-1809 Ph: () - | Dr Michael Jin Kim, MD 101 Bodin Cir, Travis Afb, CA 94535-1809 Ph: (707) 423-3749 | 
| Dr. Patrick Aaron Shea, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-3369 | |
| Brett C Johnson, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-3383 | |
| Dr. Breanna L Gawrys, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-3057 | |
| Courtney Ann Dawley, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-3000 Fax: 707-423-3501 | |
| Dr. Brian M Davis, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-7113 | |
| Dr. David M Olson, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 101 Bodin Circle, Travis Afb, CA 94535 Phone: 707-423-3842 | |
| Dr. Kristen Elizabeth Taleck, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-7622 |