Individual
DR. JENNIFER KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1425 S MAIN ST, WALNUT CREEK, CA 94596-5318
(925) 295-4000
Mailing address
231 MARKET PL # 264, SAN RAMON, CA 94583-4743
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4012
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E40120
—
CA
05
—
000E40121
—
CA
Enumeration date
02/19/2007
Last updated
03/18/2008
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