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Contact Information

PETER KIM MD INC
1195 ROADRUNNER WAY
SIMI VALLEY, CA93065-1210
 Phone: 805-579-8892
 Fax: 805-579-8951
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurology

2084N0400X 13 Physician/Neurology
 

Clinical Neurophysiology

2084N0600X 86 Physician/Neuropsychiatry
 

Neuromuscular Medicine

2084N0008X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for PETER KIM MD INC

NPI Number 1760411946
LBN Legal business name PETER KIM MD INC
Authorized official PETER KIM - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 07/01/2006
Last updated 02/12/2013 - About 13 years ago
Identifiers
CA License # A67819
CA Medicaid 00A678190
CA Other 609916600 ACS FECA ID
CA Other ZZZ50179Z BLUE SHIELD OF CA
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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