Individual
GINA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-4000
Mailing address
20 DAVIS AVE, BROOMALL, PA 19008-2101
(267) 684-9634
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA064431
PA
Other
Enumeration date
03/23/2023
Last updated
03/23/2023
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