Individual
DANIEL KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-2178
Mailing address
1410 N GRAND AVE, #M, COVINA, CA 91724-1064
(310) 720-5739
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA53827
CA
Other
Enumeration date
09/14/2016
Last updated
12/08/2016
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