Individual
IL NAM KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.AC.
Contact information
Practice address
1485 SPRUCE ST, SUITE P, RIVERSIDE, CA 92507-2445
(951) 682-8167
Mailing address
23978 BOULDER OAKS DR, CORONA, CA 92883-4151
(714) 595-7377
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
AC 11248
CA
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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