Individual
HANNAH SUH KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
9961 SIERRA AVE, FONTANA, CA 92335-6720
(909) 427-5000
Mailing address
9961 SIERRA AVE, FONTANA, CA 92335-6720
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
IN THE PROCESS
CA
363AM0700X
Medical Physician Assistant
Primary
PA21208
CA
Other
Enumeration date
09/15/2010
Last updated
12/14/2021
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