DR. KENNETH JAE YOON KIM MD NPI 1124221924

NPI Information

DR. Kenneth Jae Yoon Kim, MD is a pediatrics in Fairfax, VA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Kenneth Jae Yoon Kim, MD NPI is 1124221924. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3930 PENDER DR
SUITE 330
FAIRFAX, VA
ZIP 22030-985
Phone: (703) 246-0022
Fax: (703) 246-0080

The CLIA number assigned to this NPI record is 49D2086276 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/8/2007 and was last updated on 11/11/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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