Most Relevant Information
Provider Data
| NPI Number: | 1003077769 |
| Provider Name: | CHARLES KIM D.O. |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | BP10032227 |
Most Important Dates
| Enumeration Date: | 06/24/2008 |
| Last Updated: | 01/20/2022 |
Provider Practice Location
3601 4TH ST
LUBBOCK
TX
794300002
Practice Location Phone/Fax
| Phone: | 8067433004 |
| Fax: |
Provider Mailing Location
906 MILWAUKEE AVE APT 609
LUBBOCK
TX
794165965
Provider Mailing Phone/Fax
| Phone: | 3059844186 |
| Fax: |