Organization
JONATHAN D KIM DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN KIM DPM (CHIEF EXECUTIVE OFFICER)
(442) 599-4470
Entity
Organization
Contact information
Practice address
190 S WALNUT GROVE AVE APT B, SAN GABRIEL, CA 91776-1757
(442) 599-4470
Mailing address
190 S WALNUT GROVE AVE APT B, SAN GABRIEL, CA 91776-1757
(442) 599-4470
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
261QP1100X
Podiatric Clinic/Center
—
—
Other
Enumeration date
05/31/2024
Last updated
05/31/2024
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