Provider Demographics
NPI:1770960809
Name:KIM, KHIJOO (MD)
Entity type:Individual
Prefix:
First Name:KHIJOO
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1010 CRENSHAW BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-2055
Mailing Address - Country:US
Mailing Address - Phone:323-732-0100
Mailing Address - Fax:424-558-8100
Practice Address - Street 1:805 W LA VETA AVE STE 110
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3933
Practice Address - Country:US
Practice Address - Phone:714-289-8800
Practice Address - Fax:714-633-9928
Is Sole Proprietor?:No
Enumeration Date:2015-04-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA145961208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics