Individual
MRS. SUSAN ELIZABETH MCKIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10666 N TORREY PINES RD, LA JOLLA, CA 92037-1027
(858) 554-8646
(858) 554-6271
Mailing address
10170 SORRENTO VALLEY RD, SAN DIEGO, CA 92121-1604
(858) 784-5888
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
25MP00121500
NJ
363AM0700X
Medical Physician Assistant
Primary
PA 15527
CA
Other
Enumeration date
08/09/2005
Last updated
11/16/2015
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