Cynthia Kim, DO
Pediatrics in Fresno, CA. Individual provider (NPI-1).
NPI number1114450004
StatusActive
Last updated in NPPESFeb 29, 2024
Details
- NPI
- 1114450004
- Entity type
- Individual (NPI-1)
- Name
- Cynthia Kim
- Credential
- DO
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 6, 2017
- Certification date
- Feb 29, 2024
- Last updated
- Feb 29, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | 20A17007 | CA | Yes |
Practice location
4770 W Herndon Ave Ste 108Fresno, CA 93722-8401
Phone 559-256-7990
Mailing address
4733 W Sunset Blvd Fl 3Los Angeles, CA 90027-6021
Other practice locations
4733 W Sunset Blvd Fl 3
Los Angeles, CA 90027-6021
Los Angeles, CA 90027-6021
Phone 559-312-7022
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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