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Contact Information

KISUNG KIM, BM
2450 SISTER MARY COLUMBA DR
RED BLUFF, CA96080-4356
 Phone: 530-527-0414
 Fax: 530-527-3720
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for KISUNG KIM · (Male)

NPI Number 1073939815
Status Active
Credentials BM
Entity Individual
Enumeration date 03/17/2014
Last updated 04/03/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • CA License # A141207
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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