Individual
ALEX KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, RN, FNP-C
Contact information
Practice address
15027 CALLE LA PALOMA, CHINO HILLS, CA 91709-5011
(909) 973-3178
Mailing address
15027 CALLE LA PALOMA, CHINO HILLS, CA 91709-5011
(909) 973-3178
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95014273
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95014273
BOARD OF REGISTERED NURSING - NURSE PRACTITIONER LICENSE
CA
Enumeration date
10/23/2020
Last updated
10/23/2020
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