Individual
DANIEL KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1505 W. 17TH ST, SAN BERNARDINO, CA 92411-2661
(909) 887-6494
(909) 887-6043
Mailing address
400 N PEPPER AVE 205, COLTON, CA 92324-1801
(909) 580-6353
(909) 580-6369
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA21292
CA
Other
Enumeration date
08/19/2011
Last updated
07/09/2015
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