Most Relevant Information
Provider Data
| NPI Number: | 1003556028 |
| Provider Name: | TRACEY SHIN KIM MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/29/2022 |
| Last Updated: | 04/02/2022 |
Provider Practice Location
751 S BASCOM AVE
SAN JOSE
CA
951282604
Practice Location Phone/Fax
| Phone: | 7146238226 |
| Fax: |
Provider Mailing Location
4749 E WHITE DOVE AVE
ORANGE
CA
928691909
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |