Individual
CHEONG KIM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
12139 MOUNT VERNON AVE, SUITE 110, GRAND TERRACE, CA 92313-5586
(909) 370-3396
Mailing address
34487 YALE DR, YUCAIPA, CA 92399-6845
(909) 790-9727
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT27372
CA
Other
Enumeration date
06/15/2006
Last updated
07/08/2007
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