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ALYSSA YOUNGJEE KIM MD A PROF CORP NPI 1730124306


NPI Information

NPI: 1730124306
Provider Name: ALYSSA YOUNGJEE KIM MD A PROF CORP

Other Name: ALYSSA YOUNGJEE KIM, M.D., A PROFESSIONAL CORPORATION

Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 05D0946552

Address:
14150 CULVER DR
SUITE 304
IRVINE, CA
ZIP 92604
Phone: (949) 786-0908
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ALYSSA YOUNGJEE KIM MD A PROF CORP is a dermatology in Irvine, CA. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. ALYSSA YOUNGJEE KIM MD A PROF CORP NPI is 1730124306. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Other Name Is Alyssa Youngjee Kim, M.d., A Professional Corporation.

The provider's business location address is:

14150 CULVER DR
SUITE 304
IRVINE, CA
ZIP 92604-315
Phone: (949) 786-0908
Fax: (949) 786-0970

The provider's authorized official is Alyssa Y. Kim .
The authorized official title is Medical Director and has the following contact phone number (949) 786-0908.

The CLIA number assigned to this NPI record is 05D0946552 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 6/18/2006 and was last updated on 6/13/2014.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ND0101XDermatologyMOHS-Micrographic SurgeryG70663CALIFORNIANo
2207ND0900XDermatologyDermatopathologyG 70663CALIFORNIANo
3207NS0135XDermatologyProcedural DermatologyG 70663CALIFORNIANo
4207N00000XDermatologyG 70663CALIFORNIAYes

Other Identifiers

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

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1Y28349MEDICARE UPIN
2W18474MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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