Individual
GINA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23361 MADERO, STE #150, MISSION VIEJO, CA 92691-2715
(949) 581-8239
Mailing address
21141 CANADA RD, APT 2A, LAKE FOREST, CA 92630-2754
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10557
CA
Other
Enumeration date
04/25/2016
Last updated
04/25/2016
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