Ilkyoon Kim MD a Prof Corp
NPI #1659516094 in Clearlake, California
Provider Information
- NPI Number
- 1659516094
- Entity Type
- Organization
- Organization Name
- Ilkyoon Kim MD a Prof Corp
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- ILKYOON KIM MD A PROF CORP
- Primary Specialty
- Exclusive Provider Organization
- Enumeration Date
- Dec 15, 2008
- Last Updated
- Apr 12, 2013
Practice Location
- Address
- 15666 18TH AVE
- City
- Clearlake
- State
- California
- ZIP Code
- 95422-9336
- Phone
- (707) 994-4210
Authorized Official
- Name
- DR. ILKYOON KIM, MD
- Title
- CEO
- Phone
- (707) 994-4210
Specialties & Taxonomy Codes
| Specialty |
|---|
| Exclusive Provider Organization |
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