Individual
JEONG MOON KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
4945 LA PALMA AVE, LA PALMA, CA 90623-2054
(562) 348-0074
Mailing address
4945 LA PALMA AVE, LA PALMA, CA 90623-2054
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
11/20/2019
Last updated
11/19/2022
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