Individual
CHAN HEE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-4001
(703) 776-7113
Mailing address
4018 ANNANDALE RD, ANNANDALE, VA 22003-2534
(703) 362-7623
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110007725
VA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
02/04/2020
Last updated
09/01/2021
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