| Sang Il Kim M.d. A Professional Corporation | |
|
12610 Ventura Blvd Studio City CA 91604-2414 | |
| (818) 505-0053 | |
| (818) 505-0343 |
| Full Name | Sang Il Kim M.d. A Professional Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 12610 Ventura Blvd, Studio City, California |
| Authorized Official Name and Position | Sang Il Kim (OWNER) |
| Authorized Official Contact | 8185050053 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sang Il Kim M.d. A Professional Corporation 12610 Ventura Blvd Studio City CA 91604-2414 Ph: (818) 505-0053 | Sang Il Kim M.d. A Professional Corporation 12610 Ventura Blvd Studio City CA 91604-2414 Ph: (818) 505-0053 |
| NPI Number | 1306199450 |
|---|---|
| Provider Enumeration Date | 10/25/2012 |
| Last Update Date | 03/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306199450 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | C42314 (California) | Primary |
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