Individual
MRS. ANNIE LEE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
26074 LUGO DR, LOMA LINDA, CA 92354-6507
(909) 631-7447
Mailing address
26074 LUGO DR, LOMA LINDA, CA 92354-6507
(909) 631-7447
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1039779
CA
Other
Enumeration date
04/11/2012
Last updated
11/14/2019
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