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Individual

KYOUNG JIN KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGNP-BC

Contact information

Practice address
15435 S WESTERN AVE STE 201, GARDENA, CA 90249-4324
(213) 215-7323
Mailing address
3185 WILSHIRE BLVD UNIT 744, LOS ANGELES, CA 90010-1252

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
714565
CA
363LA2200X
Adult Health Nurse Practitioner
NP95006053
CA
363LG0600X
Gerontology Nurse Practitioner
NP95006053
CA
363LP2300X
Primary Care Nurse Practitioner
Primary
NP95006053
CA

Other

Enumeration date
08/17/2017
Last updated
08/17/2017
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