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MISS MARIA ASTRID KIM JIMENEZ GRACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
330 GOLDEN SHR, SUITE 250, LONG BEACH, CA 90802-4246
(562) 256-7550
(800) 985-5002
Mailing address
8091 CONSTANTINE DR APT 4, HUNTINGTON BEACH, CA 92646-1726
(714) 483-4970

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
AT9671
CA

Other

Enumeration date
03/25/2015
Last updated
03/25/2015
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