Individual
DEBORA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
(909) 558-4200
(909) 558-4212
Mailing address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95016799
CA
Other
Enumeration date
09/08/2021
Last updated
07/20/2022
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