Individual
MR. CHANG PA KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17051 BEAR VALLEY RD, HESPERIA, CA 92345-1845
(760) 948-7901
Mailing address
4380 SANDY RIVER DR UNIT 38, LAS VEGAS, NV 89103-6194
(702) 540-9878
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
46530
CA
Other
Enumeration date
10/14/2011
Last updated
10/14/2011
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