Provider Demographics
NPI:1700364981
Name:KIM, YIYING (PAC)
Entity type:Individual
Prefix:
First Name:YIYING
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1761 BEALL AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-2342
Mailing Address - Country:US
Mailing Address - Phone:302-023-3503
Mailing Address - Fax:330-202-3356
Practice Address - Street 1:1761 BEALL AVE STE 104
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-2342
Practice Address - Country:US
Practice Address - Phone:330-202-3350
Practice Address - Fax:330-202-3356
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.009405RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant