Individual
JAY KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12912 BROOKHURST ST STE 480, GARDEN GROVE, CA 92840-4867
(714) 636-9095
Mailing address
12912 BROOKHURST ST STE 480, GARDEN GROVE, CA 92840-4867
(714) 636-9095
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/10/2016
Last updated
07/20/2023
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