Individual
MRS. JEONGSIM KIM IZADI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2814 MONTAIR PL, UNION CITY, CA 94587-1680
(510) 907-0014
Mailing address
2814 MONTAIR PL, UNION CITY, CA 94587-1680
(510) 907-0014
Taxonomy
Speciality
Code
Description
License number
State
163WH1000X
Hospice Registered Nurse
D2102705
CA
363L00000X
Nurse Practitioner
Primary
95016945
CA
Other
Enumeration date
10/08/2020
Last updated
08/20/2021
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