Individual
EUN JUNG KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 LOXLEY PL, WALNUT, CA 91789-4808
(909) 762-4414
Mailing address
1115 LOXLEY PL, WALNUT, CA 91789-4808
(909) 762-4414
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95021811
CA
Other
Enumeration date
08/10/2022
Last updated
08/10/2022
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