Kim, Steven Park

Kim, Steven Park is an individual health care provider with primary practice located at 4761 Hoen Ave , Santa Rosa CA 95405-7862. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Kim, Steven Park can be contacted via phone (707) 545-0570.

Contact Information

Primary practice address
4761 Hoen Ave Santa Rosa CA 95405-7862
Phone: (707) 545-0570
Fax: (707) 545-0575
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X E4506 California

Profile Details

NPI number 1306877006
LBN Legal business name Kim, Steven Park
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Apr 18th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306877006 NPPES
California Other P01011615 RAILROAD MEDICARE
California MEDICAID 000E45060 RAILROAD MEDICARE

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