Provider Demographics
NPI:1437237005
Name:KIM, RAN S (MD)
Entity type:Individual
Prefix:DR
First Name:RAN
Middle Name:S
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1399 YGNACIO VALLEY RD STE 11D
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2874
Mailing Address - Country:US
Mailing Address - Phone:925-430-5613
Mailing Address - Fax:510-340-5462
Practice Address - Street 1:1399 YGNACIO VALLEY RD STE 11D
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2874
Practice Address - Country:US
Practice Address - Phone:925-430-5613
Practice Address - Fax:510-340-5462
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75587208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G755870Medicare ID - Type Unspecified
CAF83274Medicare UPIN