Individual
CHRISTINA CHAN KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9449 IMPERIAL HWY, BUILDING A, SUITE 309, DOWNEY, CA 90242-2814
(562) 657-2483
Mailing address
2282 CLARK DR, FULLERTON, CA 92833-5616
(951) 323-2132
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA22672
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA22672
LICENSE
CA
Enumeration date
11/02/2012
Last updated
12/27/2021
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