Individual
WANDA SUE KIM-HAYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
111 E VICTORIA ST, SANTA BARBARA, CA 93101-2018
(805) 564-3233
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-8707
(805) 687-5530
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA20523
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1086592
NAT'L COMM ON CERTIFICATION OF PHYSICIAN ASSISTANTS
CA
01
—
PA20523
LICENSE
—
Enumeration date
10/22/2009
Last updated
10/03/2024
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