Individual
STEPHANIE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1260 VETERAN AVE APT 108, LOS ANGELES, CA 90024-0059
(201) 450-3642
Mailing address
1260 VETERAN AVE APT 108, LOS ANGELES, CA 90024-0059
(201) 450-3642
Taxonomy
Speciality
Code
Description
License number
State
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
95018364
CA
Other
Enumeration date
01/07/2022
Last updated
01/07/2022
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